Provider Demographics
NPI:1598054215
Name:ROMERO, AMALIA SEVILLA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:AMALIA
Middle Name:SEVILLA
Last Name:ROMERO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:AMALIA
Other - Middle Name:G
Other - Last Name:SEVILLA-ROMERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5411 SUPERIOR AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-1344
Mailing Address - Country:US
Mailing Address - Phone:216-431-5643
Mailing Address - Fax:216-431-4482
Practice Address - Street 1:5411 SUPERIOR AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-1344
Practice Address - Country:US
Practice Address - Phone:216-431-5643
Practice Address - Fax:216-431-4482
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03327093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist