Provider Demographics
NPI:1013027259
Name:ROMEO, LAUREN E (MD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:ROMEO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 MINUTEMEN CSWY
Mailing Address - Street 2:
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-2881
Mailing Address - Country:US
Mailing Address - Phone:321-302-6266
Mailing Address - Fax:321-406-0228
Practice Address - Street 1:465 MINUTEMEN CSWY
Practice Address - Street 2:
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-2881
Practice Address - Country:US
Practice Address - Phone:321-302-6266
Practice Address - Fax:321-406-0228
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92448207Q00000X, 2083P0011X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274167900Medicaid
FLI42543Medicare UPIN
FL274167900Medicaid