Provider Demographics
NPI:1598562068
Name:ROMERO, ANISLEY
Entity type:Individual
Prefix:
First Name:ANISLEY
Middle Name:
Last Name:ROMERO
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 1:13200 SW 128TH ST STE E2
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5831
Mailing Address - Country:US
Mailing Address - Phone:786-250-3223
Mailing Address - Fax:813-736-4898
Practice Address - Street 1:20021 GULFSTREAM RD
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1543
Practice Address - Country:US
Practice Address - Phone:305-764-6408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty