Healthcare Provider Details

I. General information

NPI: 1225369374
Provider Name (Legal Business Name): MILCIADES ROMERO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2010
Last Update Date: 01/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STREET 13 CORNER AVE. D #2068
SAN JUAN PR
00917
US

IV. Provider business mailing address

PO BOX 8698
SAN JUAN PR
00910-0698
US

V. Phone/Fax

Practice location:
  • Phone: 787-525-7496
  • Fax:
Mailing address:
  • Phone: 787-525-7496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberTC AMB 588
License Number StatePR

VIII. Authorized Official

Name: MS. MARY ELAINE ROMERO
Title or Position: SECRETARY
Credential:
Phone: 787-513-6775