Provider Demographics
NPI:1659604668
Name:ROMERO, ADAM (LPN)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:ROMERO
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 NW 25TH ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33122-1625
Mailing Address - Country:US
Mailing Address - Phone:305-593-2174
Mailing Address - Fax:
Practice Address - Street 1:7800 NW 25TH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33122-1625
Practice Address - Country:US
Practice Address - Phone:305-593-2174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2009-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5169400164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse