Provider Demographics
NPI:1437440468
Name:ROMERO, MANUEL (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:
Last Name:ROMERO
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 SW 57TH AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5775
Mailing Address - Country:US
Mailing Address - Phone:305-265-3267
Mailing Address - Fax:305-265-3267
Practice Address - Street 1:1350 SW 57TH AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5775
Practice Address - Country:US
Practice Address - Phone:305-265-3267
Practice Address - Fax:305-265-3267
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 60500225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist