Provider Demographics
NPI:1033981006
Name:CONNER, ROMEO
Entity Type:Individual
Prefix:
First Name:ROMEO
Middle Name:
Last Name:CONNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 W LAMBRIGHT ST APT 214
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-4704
Mailing Address - Country:US
Mailing Address - Phone:574-350-9252
Mailing Address - Fax:
Practice Address - Street 1:3130 W LAMBRIGHT ST APT 214
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-4704
Practice Address - Country:US
Practice Address - Phone:574-350-9252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician