MEDICARE: GISELLE ROMERO GREGORICH

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1386531671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GISELLE ROMERO GREGORICH

Provider Business Mailing Address
First Line	:	1250 N MARION ST APT 313
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-3310
Country	:	US
Telephone Number	:	424-541-0118
Fax Number	:	424-541-0118

Provider Business Practice Location Address
First Line	:	4236 W LINEBAUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-5241
Country	:	US
Telephone Number	:	813-557-1525
Fax Number	:	813-435-2015

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

Provider Enumeration Date	:	06/19/2025
Last Update Date	:	06/19/2025

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