Provider Demographics
NPI:1194936757
Name:ROMERO MARRERO, CARLOS J (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:J
Last Name:ROMERO MARRERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7369 SHERIDAN ST STE 300
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2776
Mailing Address - Country:US
Mailing Address - Phone:954-451-5932
Mailing Address - Fax:
Practice Address - Street 1:7369 SHERIDAN ST STE 300
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2776
Practice Address - Country:US
Practice Address - Phone:954-451-5932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH096715207RG0100X, 207RI0008X
MN104577207RG0100X
390200000X
FLME147148207RG0100X
PR15391207R00000X
MN52354207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNENROLLEDMedicaid
IAENROLLEDMedicaid
IAENROLLEDMedicaid