Provider Demographics
NPI:1114141025
Name:ROMAN, SONIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:A
Last Name:ROMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DC4 CALLE MONTES
Mailing Address - Street 2:VALLE VERDE 3
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961-3341
Mailing Address - Country:US
Mailing Address - Phone:787-261-7632
Mailing Address - Fax:
Practice Address - Street 1:DC4 CALLE MONTES
Practice Address - Street 2:VALLE VERDE 3
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-3341
Practice Address - Country:US
Practice Address - Phone:787-261-7632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR109092083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR10909OtherMD