Provider Demographics
NPI:1679573604
Name:ROMERO, MANUEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:L
Last Name:ROMERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MANUEL
Other - Middle Name:L
Other - Last Name:ROMERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5450 SW 8TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2200
Mailing Address - Country:US
Mailing Address - Phone:305-967-8381
Mailing Address - Fax:305-967-8394
Practice Address - Street 1:5450 SW 8TH ST STE 202
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2200
Practice Address - Country:US
Practice Address - Phone:305-967-8381
Practice Address - Fax:305-967-8394
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME43500208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255513100Medicaid
FL255513100Medicaid
D27983Medicare UPIN