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General NPI Number Information
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NPI Number | 1013919513
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Entity Type | Individual
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Provider Name | CRAIG JOSEPH ROMERO PHYSICIAN ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 09/27/2009
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Provider Practice Location Address
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Address Line | 1000 36TH ST
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City | VERO BEACH
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State | FL
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Zip | 32960-4862
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Country | US
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Telephone | 772-567-4311
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Fax | 772-563-4706
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Provider Business Mailing Address
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Address Line | 5160 COMPASS POINTE CIR
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City | VERO BEACH
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State | FL
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Zip | 32966-2118
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Country | US
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Telephone | 772-562-9116
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9101323
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License Number State | FL
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