Provider Demographics
NPI:1508115742
Name:ROMERO, JOSEPHINE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:
Last Name:ROMERO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17605 HAMLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-2678
Mailing Address - Country:US
Mailing Address - Phone:561-792-4098
Mailing Address - Fax:888-740-6923
Practice Address - Street 1:17605 HAMLIN BLVD
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-2678
Practice Address - Country:US
Practice Address - Phone:561-792-4098
Practice Address - Fax:888-740-6923
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9103797363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant