Provider Demographics
NPI:1003446741
Name:ROMERO CARRERO, JOSE A
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:A
Last Name:ROMERO CARRERO
Suffix:
Gender:M
Credentials:
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 63
Mailing Address - Street 2:
Mailing Address - City:LARES
Mailing Address - State:PR
Mailing Address - Zip Code:00669-0063
Mailing Address - Country:US
Mailing Address - Phone:787-897-2814
Mailing Address - Fax:787-897-5075
Practice Address - Street 1:CARR.129 INT. CARR.111 KM 23.2 CRUCE MIJAN
Practice Address - Street 2:
Practice Address - City:LARES
Practice Address - State:PR
Practice Address - Zip Code:00669
Practice Address - Country:US
Practice Address - Phone:787-897-2814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3131183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist