Healthcare Provider Details

I. General information

NPI: 1750190633
Provider Name (Legal Business Name): MILAGROS ROMERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2025
Last Update Date: 01/04/2025
Certification Date: 01/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3503 BANQUO DR
SILVER SPRING MD
20906
US

IV. Provider business mailing address

3503 BANQUO DR
SILVER SPRING MD
20906
US

V. Phone/Fax

Practice location:
  • Phone: 240-787-9684
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number3893
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: