Healthcare Provider Details

I. General information

NPI: 1033812847
Provider Name (Legal Business Name): RICHMOND ESPIRITU ROMERO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12902 USF MAGNOLIA DR
TAMPA FL
33612-9416
US

IV. Provider business mailing address

5450 BAY CENTER DR
TAMPA FL
33609-3658
US

V. Phone/Fax

Practice location:
  • Phone: 813-745-4673
  • Fax: 813-449-8618
Mailing address:
  • Phone: 813-745-4673
  • Fax: 813-449-8618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11033276
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704295021
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: