Provider Demographics
NPI:1255309290
Name:ROMAN, RAMIRO (MD)
Entity Type:Individual
Prefix:
First Name:RAMIRO
Middle Name:
Last Name:ROMAN
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 1:1672 CALLE MARQUESA
Mailing Address - Street 2:VALLE REAL
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-0504
Mailing Address - Country:US
Mailing Address - Phone:787-319-1202
Mailing Address - Fax:
Practice Address - Street 1:8118 CALLE CONCORDIA
Practice Address - Street 2:GALERIA PROFESIONAL, SUITE 102
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1562
Practice Address - Country:US
Practice Address - Phone:787-844-4600
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6455208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics