MEDICARE: MRS. GLORIA ROMERO

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	231H00000X	Audiologist	0215137	CO

General Provider Information

NPI Number	:	1124354378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GLORIA ROMERO

Provider Business Mailing Address
First Line	:	620 SAN CLEMENTE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4911
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 SAN CLEMENTE DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4911
Country	:	US
Telephone Number	:	719-527-4311
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2009
Last Update Date	:	10/22/2009

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Directions to “ MRS. GLORIA ROMERO ” Practice Location

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