Provider Demographics
NPI:1871748558
Name:ROMERO FAMILY MEDICINE PLLC
Entity type:Organization
Organization Name:ROMERO FAMILY MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-553-2122
Mailing Address - Street 1:1865 N CORPORATE LAKES BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3273
Mailing Address - Country:US
Mailing Address - Phone:954-349-4391
Mailing Address - Fax:954-349-4847
Practice Address - Street 1:1865 N CORPORATE LAKES BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3273
Practice Address - Country:US
Practice Address - Phone:954-349-4391
Practice Address - Fax:954-349-4847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2014-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 6955261QP2300X
FLOS 6934261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL72825OtherBCBS