Provider Demographics
NPI:1619712627
Name:ROMERO PAGES, MARCOS ANTONIO
Entity type:Individual
Prefix:
First Name:MARCOS
Middle Name:ANTONIO
Last Name:ROMERO PAGES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6757 N KENDALL DR APT C308
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-1792
Mailing Address - Country:US
Mailing Address - Phone:786-834-6819
Mailing Address - Fax:
Practice Address - Street 1:6757 N KENDALL DR APT C308
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-1792
Practice Address - Country:US
Practice Address - Phone:786-834-6819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-334935106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician