Healthcare Provider Details

I. General information

NPI: 1821463472
Provider Name (Legal Business Name): CHRISTIAN E ROMERO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CHRISTIAN E ROMERO MHS

II. Dates (important events)

Enumeration Date: 12/08/2015
Last Update Date: 01/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 4 E2 ROSA MARIA
CAROLINA PUERTO RICO
00985
UM

IV. Provider business mailing address

E2 CALLE 4 URB ROSA MARIA
CAROLINA PR
00985
US

V. Phone/Fax

Practice location:
  • Phone: 787-364-0888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1154
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1154
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: