Healthcare Provider Details

I. General information

NPI: 1679499420
Provider Name (Legal Business Name): MIA ROMERO BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9425 SW 72ND ST STE 164
MIAMI FL
33173-3290
US

IV. Provider business mailing address

5701 SW 94TH PL
MIAMI FL
33173-1535
US

V. Phone/Fax

Practice location:
  • Phone: 305-279-2286
  • Fax:
Mailing address:
  • Phone: 786-483-5536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-26-17238
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: