Provider Demographics
NPI:1720627904
Name:ROMERO, HUGO GERSHUN (SA-C)
Entity Type:Individual
Prefix:MR
First Name:HUGO
Middle Name:GERSHUN
Last Name:ROMERO
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5291 SW 89TH PL # 5291
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-3868
Mailing Address - Country:US
Mailing Address - Phone:352-426-3204
Mailing Address - Fax:
Practice Address - Street 1:5291 SW 89TH PL
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-3868
Practice Address - Country:US
Practice Address - Phone:352-426-3204
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-05
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19-527246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant