Provider Demographics
NPI:1073997425
Name:ROMERO, RAFAEL (CSFA)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:
Last Name:ROMERO
Suffix:
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3770 SEVEN SEAS AVE
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34638-2906
Mailing Address - Country:US
Mailing Address - Phone:727-375-7091
Mailing Address - Fax:
Practice Address - Street 1:3770 SEVEN SEAS AVE
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-2906
Practice Address - Country:US
Practice Address - Phone:727-375-7091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant