MEDICARE: LINDA ROMERO PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QH0100X	Health Service Clinic/Center		NM

General Provider Information

NPI Number	:	1053765511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINDA ROMERO PA

Provider Business Mailing Address
First Line	:	500 MARQUETTE AVE NW
Second Line	:	SUITE 1200
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-5340
Country	:	US
Telephone Number	:	505-385-5350
Fax Number	:	505-213-7783

Provider Business Practice Location Address
First Line	:	500 MARQUETTE AVE NW
Second Line	:	SUITE 1200
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-5340
Country	:	US
Telephone Number	:	505-385-5350
Fax Number	:	505-213-7783

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	LINDA ROMERO
Credential	:
Telephone Number	:	505-385-5350

Provider Enumeration Date	:	04/20/2016
Last Update Date	:	04/20/2016

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Directions to “LINDA ROMERO PA ” Practice Location

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