Provider Demographics
NPI:1467753046
Name:ROMERO, ELSA (273439526)
Entity Type:Individual
Prefix:
First Name:ELSA
Middle Name:
Last Name:ROMERO
Suffix:
Gender:F
Credentials:273439526
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7801 CORAL WAY
Mailing Address - Street 2:SUITE # 121
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155
Mailing Address - Country:US
Mailing Address - Phone:305-267-8752
Mailing Address - Fax:305-265-0298
Practice Address - Street 1:7801 CORAL WAY
Practice Address - Street 2:SUITE # 121
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6538
Practice Address - Country:US
Practice Address - Phone:305-267-8752
Practice Address - Fax:305-265-0298
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL273439526225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273439526OtherCLINIC/CENTER