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General NPI Number Information
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NPI Number | 1083847727
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Entity Type | Organization
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Legal Business Name | ROMULO CLAVELO M D P A
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Dates
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Enumeration Date | 08/28/2009
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 78 SW 13TH AVE SUITE 201
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City | MIAMI
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State | FL
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Zip | 33135-2479
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Country | US
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Telephone | 305-631-0470
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 402054
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City | MIAMI BEACH
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State | FL
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Zip | 33140-0054
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROMULO CLAVELO
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Credential | M.D.
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Telephone | 786-543-5581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME90231
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License Number State | FL
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