Basic Information
Provider Information
NPI: 1487676417
EntityType: 2
ReplacementNPI:  
OrganizationName: UNIVERSITY OF MIAMI
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: UMHC ANESTHESIA SERVICES
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1611 NW 12TH AVE
Address2: BOX 016960 M851
City: MIAMI
State: FL
PostalCode: 331361005
CountryCode: US
TelephoneNumber: 3052437688
FaxNumber:  
Practice Location
Address1: 1611 NW 12TH AVE
Address2: BOX 016960 M851
City: MIAMI
State: FL
PostalCode: 331361005
CountryCode: US
TelephoneNumber: 3052437688
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/25/2006
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: ROMILLO
AuthorizedOfficialFirstName: GEMMA
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: DIRECTOR BILLING COMPLIANCE
AuthorizedOfficialTelephone: 3052435842
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X  Y193400000X SINGLE SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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