Provider Demographics
NPI:1427110683
Name:ROMERO, SILVIA DIVINETZ (MD)
Entity type:Individual
Prefix:DR
First Name:SILVIA
Middle Name:DIVINETZ
Last Name:ROMERO
Suffix:
Gender:F
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:P.O. BOX 23622
Mailing Address - Street 2:825 W 65TH ST
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-1527
Mailing Address - Country:US
Mailing Address - Phone:612-872-1500
Mailing Address - Fax:888-972-5304
Practice Address - Street 1:5200 WILLSON RD.
Practice Address - Street 2:#405
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55423
Practice Address - Country:US
Practice Address - Phone:612-872-1500
Practice Address - Fax:888-972-5304
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN24545174400000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No174400000XOther Service ProvidersSpecialist