Healthcare Provider Details

I. General information

NPI: 1861192064
Provider Name (Legal Business Name): JESSLYN MARIE ROMERO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 KRAFT RD STE 300
NAPLES FL
34105-5020
US

IV. Provider business mailing address

PO BOX 102222
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 239-353-6636
  • Fax: 239-354-1865
Mailing address:
  • Phone: 239-432-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11024979
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: