Individual
ALISA K ROMERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12700 CREEKSIDE LANE, SUITE 101, FORT MYERS, FL 33919-3356
(239) 432-0774
(239) 432-9404
Mailing address
12700 CREEKSIDE LANE, SUITE 101, FORT MYERS, FL 33919-3356
(239) 432-0774
(239) 432-0229
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9105863
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003261200
—
FL
01
—
Y06NS
BCBS
FL
Enumeration date
02/01/2011
Last updated
11/06/2013
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