Healthcare Provider Details

I. General information

NPI: 1053863076
Provider Name (Legal Business Name): KIRENIA ROMERO GONZALEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9130 NW 162ND TER
MIAMI LAKES FL
33018-6302
US

IV. Provider business mailing address

9130 NW 162ND TER
MIAMI LAKES FL
33018-6302
US

V. Phone/Fax

Practice location:
  • Phone: 786-870-3174
  • Fax:
Mailing address:
  • Phone: 786-870-3174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-48164
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA24721
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: