Provider Demographics
NPI:1447365192
Name:ROMERO, EDGAR PHILLIP (DC)
Entity type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:PHILLIP
Last Name:ROMERO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 SW 27TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-2544
Mailing Address - Country:US
Mailing Address - Phone:305-445-3130
Mailing Address - Fax:
Practice Address - Street 1:1960 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-2544
Practice Address - Country:US
Practice Address - Phone:305-445-3130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0006566111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU40944Medicare UPIN
FL24318Medicare ID - Type Unspecified