Individual
DR. JESSICA VANESSA ROMERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3381 PHILLIS BLVD, MYRTLE BEACH, SC 29577-1560
(843) 577-7011
Mailing address
3381 PHILLIS BLVD, MYRTLE BEACH, SC 29577-1560
(843) 577-7011
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
15539
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022929RO
TRIPLE S
PR
01
—
3953
PMC M MEDICARE CHOICE
PR
01
—
7380082
HUMANA
PR
01
—
M000611
MENONITA
PR
Enumeration date
08/30/2006
Last updated
02/16/2016
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