MEDICARE: IRENE DE LOS ANGELES ROMERO REDONDO RD

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	133V00000X	Registered Dietitian	300755	KY

General Provider Information

NPI Number	:	1679431100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRENE DE LOS ANGELES ROMERO REDONDO RD

Provider Business Mailing Address
First Line	:	UNIVERSITY OF KENTUCKY HOSPITAL 800 ROSE STREET
Second Line	:	OFFICE H038
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0001
Country	:	US
Telephone Number	:	859-218-0899
Fax Number	:

Provider Business Practice Location Address
First Line	:	UNIVERSITY OF KENTUCKY HOSPITAL 800 ROSE STREET
Second Line	:	OFFICE H038
City	:	LEXINGTON
State	:	KY
Zip	:	40536-0001
Country	:	US
Telephone Number	:	859-218-0899
Fax Number	:

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

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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