Provider Demographics
NPI:1972575967
Name:COLINA, ROMEO S (MD)
Entity Type:Individual
Prefix:DR
First Name:ROMEO
Middle Name:S
Last Name:COLINA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1900 NEBRASKA AVE
Mailing Address - Street 2:#8
Mailing Address - City:FT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4837
Mailing Address - Country:US
Mailing Address - Phone:772-465-2055
Mailing Address - Fax:772-465-0328
Practice Address - Street 1:1900 NEBRASKA AVE
Practice Address - Street 2:#8
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4837
Practice Address - Country:US
Practice Address - Phone:772-465-2055
Practice Address - Fax:772-465-0328
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2010-09-09
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Provider Licenses
StateLicense IDTaxonomies
FLME29220207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL043970300Medicaid
FL043970300Medicaid
D56758Medicare UPIN