Provider Demographics
NPI:1114433877
Name:ROMERO, MASSIEL
Entity Type:Individual
Prefix:
First Name:MASSIEL
Middle Name:
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 1:19894 SW 129TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-4226
Mailing Address - Country:US
Mailing Address - Phone:305-256-1653
Mailing Address - Fax:305-256-1663
Practice Address - Street 1:19894 SW 129TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-4226
Practice Address - Country:US
Practice Address - Phone:305-256-1653
Practice Address - Fax:305-256-1663
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician