Healthcare Provider Details

I. General information

NPI: 1801610563
Provider Name (Legal Business Name): LIANET M ROMERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2898 NW 79TH AVE
MIAMI FL
33122-1033
US

IV. Provider business mailing address

4225 SW 136TH PL
MIAMI FL
33175-3751
US

V. Phone/Fax

Practice location:
  • Phone: 305-363-2969
  • Fax:
Mailing address:
  • Phone: 786-439-5312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: