Healthcare Provider Details

I. General information

NPI: 1770727240
Provider Name (Legal Business Name): MR. MILCIADES ROMERO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 04/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 13 ESQUINA CALLE D
SAN JUAN PR
00910
US

IV. Provider business mailing address

PO BOX 6886
SAN JUAN PR
00910
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 Code3416L0300X
TaxonomyLand Ambulance
License NumberTC AMB 588
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: