Provider Demographics
NPI:1295867869
Name:ROMAN, ALICEBEL (PHARM D)
Entity Type:Individual
Prefix:
First Name:ALICEBEL
Middle Name:
Last Name:ROMAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 58 BOX 13669
Mailing Address - Street 2:
Mailing Address - City:AGUADA
Mailing Address - State:PR
Mailing Address - Zip Code:00602-9724
Mailing Address - Country:US
Mailing Address - Phone:787-252-2611
Mailing Address - Fax:
Practice Address - Street 1:HC 58 BOX 13669
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-9724
Practice Address - Country:US
Practice Address - Phone:787-252-2611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist