Provider Demographics
NPI:1043740665
Name:ROMERO, CRISELDA VERONICA
Entity Type:Individual
Prefix:
First Name:CRISELDA
Middle Name:VERONICA
Last Name:ROMERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24009 MADACA LN UNIT 104
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33954-2804
Mailing Address - Country:US
Mailing Address - Phone:941-536-6257
Mailing Address - Fax:
Practice Address - Street 1:24009 MADACA LANE
Practice Address - Street 2:APT 104
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33954
Practice Address - Country:US
Practice Address - Phone:941-536-6257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL337608376K00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty