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General NPI Number Information
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NPI Number | 1114747524
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Entity Type | Individual
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Provider Name | MAURICIO PALACIOS ROMERO NP
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Gender | Male
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 1950 W 3RD ST
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City | YUMA
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State | AZ
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Zip | 85364-1812
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Country | US
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Telephone | 928-276-4477
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Fax | 928-276-4481
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Provider Business Mailing Address
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Address Line | 4279 W 27TH PL
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City | YUMA
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State | AZ
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Zip | 85364-4696
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Country | US
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Telephone | 928-366-9225
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 239288
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License Number State | AZ
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