Provider Demographics
NPI:1144230533
Name:CHAVIER ROPER, ROLANCE G (MD)
Entity Type:Individual
Prefix:DR
First Name:ROLANCE
Middle Name:G
Last Name:CHAVIER ROPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 CALLE WILLIAM JONES
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00925-3441
Mailing Address - Country:US
Mailing Address - Phone:787-612-8765
Mailing Address - Fax:787-763-5801
Practice Address - Street 1:1107 CALLE WILLIAM JONES
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-3441
Practice Address - Country:US
Practice Address - Phone:787-612-8765
Practice Address - Fax:787-763-5801
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11519208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR11519OtherSTATE LICENSE
PR11519OtherSTATE LICENSE
PRCH-84449Medicare ID - Type Unspecified