Healthcare Provider Details

I. General information

NPI: 1659725588
Provider Name (Legal Business Name): MLINDSEY ROMERO DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2016
Last Update Date: 04/29/2024
Certification Date: 04/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 N 400 W # C12
OREM UT
84057-1909
US

IV. Provider business mailing address

171 N 400 W # C12
OREM UT
84057-1909
US

V. Phone/Fax

Practice location:
  • Phone: 801-224-4550
  • Fax:
Mailing address:
  • Phone: 801-224-4550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number11961059-1204
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: