Provider Demographics
NPI:1215734959
Name:ROMERO ROSA, MARCOS
Entity type:Individual
Prefix:
First Name:MARCOS
Middle Name:
Last Name:ROMERO ROSA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11851 SW 42ND PL UNIT 314
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-8071
Mailing Address - Country:US
Mailing Address - Phone:787-412-6995
Mailing Address - Fax:
Practice Address - Street 1:8250 MILLS DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-4805
Practice Address - Country:US
Practice Address - Phone:305-274-2420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS67935183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist