MEDICARE: CARMEN MARINA ROMERO MH

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	MH 8781	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MH 8781	OTHER	FL	MENTAL HEALTH COUNSELOR

General Provider Information

NPI Number	:	1265608988
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN MARINA ROMERO MH

Provider Business Mailing Address
First Line	:	755 E 8TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-4613
Country	:	US
Telephone Number	:	305-888-5730
Fax Number	:	305-888-5732

Provider Business Practice Location Address
First Line	:	755 E 8TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-4613
Country	:	US
Telephone Number	:	305-888-5730
Fax Number	:	305-888-5732

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

Provider Enumeration Date	:	05/02/2008
Last Update Date	:	05/02/2008

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