Provider Demographics
NPI:1598865594
Name:FLORA-GOMEZ, ROMEO GALINATO (LCSW)
Entity Type:Individual
Prefix:
First Name:ROMEO
Middle Name:GALINATO
Last Name:FLORA-GOMEZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:R
Other - Last Name:FLORA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1441 KAPIOLANI BLVD FL 16
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4402
Mailing Address - Country:US
Mailing Address - Phone:808-432-7600
Mailing Address - Fax:
Practice Address - Street 1:4441 E KINGS CANYON RD
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-3604
Practice Address - Country:US
Practice Address - Phone:559-600-7182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-33741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000262907OtherHMSA BILLING NUMBER
HI58875901Medicaid
CA0Medicaid