Healthcare Provider Details

I. General information

NPI: 1639015845
Provider Name (Legal Business Name): ABIGAIL MARIE ROMERO PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABIGAIL MARIE ZURBRIGGEN PA

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4550 E STATE RD 20 STE L
NICEVILLE FL
32578
US

IV. Provider business mailing address

224 BENNING DR
DESTIN FL
32541-2410
US

V. Phone/Fax

Practice location:
  • Phone: 850-530-6064
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: