Raul Romero, IDMT
Individual provider Active NPI Independent Duty Medical Technicians · Dmafb, AZ
NPI 1164657136 · NPPES record last updated May 20, 2009
Key facts
- NPI
- 1164657136
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Independent Duty Medical Technicians 1710I1003X
- Practice address
- 4575 S. Phoenix St. 563Rd Oss
Dmafb, AZ 85707 - Phone
- (520) 228-1859
- NPI assigned
- May 20, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Medical Technicians | 1710I1003X | Yes |
Addresses
Primary practice location
4575 S. Phoenix St. 563Rd Oss
Dmafb, AZ 85707
Mailing address
4575 S. Phoenix St. 563Rd Oss
Dmafb, AZ 85707
Other providers in Dmafb, AZ
All providers in Dmafb, AZ · Independent Duty Medical Technicians in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.