Provider Demographics
NPI:1437820032
Name:ROMERO, ALEJANDRO JAVIER (IDHS)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:JAVIER
Last Name:ROMERO
Suffix:
Gender:M
Credentials:IDHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9235 GROUPER RD # 617
Mailing Address - Street 2:
Mailing Address - City:CAPE CANAVERAL
Mailing Address - State:FL
Mailing Address - Zip Code:32920-4499
Mailing Address - Country:US
Mailing Address - Phone:321-868-4228
Mailing Address - Fax:
Practice Address - Street 1:9235 GROUPER RD # 617
Practice Address - Street 2:
Practice Address - City:CAPE CANAVERAL
Practice Address - State:FL
Practice Address - Zip Code:32920-4499
Practice Address - Country:US
Practice Address - Phone:321-868-4228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman