Provider Demographics
NPI:1750443370
Name:ROMERO MEREJO, DOMINGO ERNESTO (MD)
Entity Type:Individual
Prefix:MR
First Name:DOMINGO
Middle Name:ERNESTO
Last Name:ROMERO MEREJO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6342
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960
Mailing Address - Country:US
Mailing Address - Phone:787-740-5524
Mailing Address - Fax:787-740-5524
Practice Address - Street 1:MEDICAL OPTHALMIC PLAZA CARR 2 KM 119
Practice Address - Street 2:S 107
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-740-5524
Practice Address - Fax:787-740-5524
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12183208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRDM125732OtherLOCAL CSR
BR5775020OtherDEA
G42508Medicare UPIN
PRDM125732OtherLOCAL CSR