Provider Demographics
NPI:1598862062
Name:ROMERO, CARLOS HUMBERTO (DO)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:HUMBERTO
Last Name:ROMERO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
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 1:1290 WESTON RD STE 203
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-1909
Practice Address - Country:US
Practice Address - Phone:954-436-8036
Practice Address - Fax:954-217-4006
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6934207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH19753Medicare UPIN
FL43442Medicare PIN