Provider Demographics
NPI:1700440443
Name:ROMERO, MARITZA
Entity Type:Individual
Prefix:
First Name:MARITZA
Middle Name:
Last Name:ROMERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COLINAS DE PLATA
Mailing Address - Street 2:8 PASEOS DEL PLATA
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-0000
Mailing Address - Country:US
Mailing Address - Phone:787-453-6156
Mailing Address - Fax:
Practice Address - Street 1:COLINAS DE PLATA
Practice Address - Street 2:8 PASEOS DEL PLATA
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-0000
Practice Address - Country:US
Practice Address - Phone:787-453-6156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5795104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1853602OtherDRIVERS LICENSE