Provider Demographics
NPI:1598024473
Name:ROMERO, MICHAEL J
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:ROMERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 PAPALANI ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3522
Mailing Address - Country:US
Mailing Address - Phone:808-387-7853
Mailing Address - Fax:
Practice Address - Street 1:1130 N NIMITZ HWY
Practice Address - Street 2:C-302
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4579
Practice Address - Country:US
Practice Address - Phone:808-845-7771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator