Provider Demographics
NPI:1164503801
Name:ROMANO, RODRIGO (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:RODRIGO
Middle Name:
Last Name:ROMANO
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 SW 62ND AVE STE A-1
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4908
Mailing Address - Country:US
Mailing Address - Phone:305-403-6222
Mailing Address - Fax:305-403-4222
Practice Address - Street 1:7701 SW 62ND AVE STE A-1
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4908
Practice Address - Country:US
Practice Address - Phone:305-403-6222
Practice Address - Fax:305-403-4222
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN169091223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics