Healthcare Provider Details

I. General information

NPI: 1821918442
Provider Name (Legal Business Name): ANDY HERMOSO ROMERO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11911 NW 32ND MNR
SUNRISE FL
33323-1219
US

IV. Provider business mailing address

11911 NW 32ND MNR
SUNRISE FL
33323-1219
US

V. Phone/Fax

Practice location:
  • Phone: 786-691-7199
  • Fax:
Mailing address:
  • Phone: 786-691-7199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06260173
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: