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General NPI Number Information
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NPI Number | 1598904732
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Entity Type | Organization
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Legal Business Name | EDUARDO G ROMERO MD PA INC
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 12/30/2011
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Provider Practice Location Address
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Address Line | 1304 OHIO AVE S
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City | LIVE OAK
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State | FL
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Zip | 32064-4156
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Country | US
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Telephone | 386-364-1211
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Fax |
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Provider Business Mailing Address
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Address Line | 1304 S. OHIO AVENUE
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City | LIVE OAK
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State | FL
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Zip | 32064
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Country | US
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Telephone | 386-364-1211
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | CYNDI B ROMERO
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Credential | R.N.
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Telephone | 386-364-1211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME32987
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License Number State | FL
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