MEDICARE: MISS JENNIFER ROMERO MS

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1255705943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JENNIFER ROMERO MS

Provider Business Mailing Address
First Line	:	3840 5TH AVE N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33713-7521
Country	:	US
Telephone Number	:	727-367-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	3840 5TH AVE. N.
Second Line	:
City	:	ST. PETERSBURG
State	:	FL
Zip	:	33713-0000
Country	:	US
Telephone Number	:	727-367-2273
Fax Number	:

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

Provider Enumeration Date	:	11/18/2015
Last Update Date	:	03/30/2016

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