Healthcare Provider Details

I. General information

NPI: 1881041358
Provider Name (Legal Business Name): WESLEY ARTHUR ROMNEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2016
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 N WICKHAM RD STE 202
MELBOURNE FL
32935-8660
US

IV. Provider business mailing address

240 N WICKHAM RD STE 202
MELBOURNE FL
32935-8660
US

V. Phone/Fax

Practice location:
  • Phone: 321-541-1746
  • Fax: 321-676-2613
Mailing address:
  • Phone: 321-541-1746
  • Fax: 321-676-2613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number164016.
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number164016.
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number164016
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: