Provider Demographics
NPI:1164472791
Name:ROMANO, GENO (MD)
Entity Type:Individual
Prefix:
First Name:GENO
Middle Name:
Last Name:ROMANO
Suffix:
Gender:M
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:PO BOX 530
Mailing Address - Street 2:
Mailing Address - City:INDIAN ROCKS BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33785-0530
Mailing Address - Country:US
Mailing Address - Phone:727-492-2100
Mailing Address - Fax:
Practice Address - Street 1:7601 SEMINOLE BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-4862
Practice Address - Country:US
Practice Address - Phone:727-394-8442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME48896207Q00000X
CAG87682207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABH926ZMedicare PIN
FL074237Medicare ID - Type Unspecified
FLD51918Medicare UPIN