Provider Demographics
NPI:1326497272
Name:PEREZ ROMAN, ANDRES (MD)
Entity Type:Individual
Prefix:
First Name:ANDRES
Middle Name:
Last Name:PEREZ ROMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:SAN JORGE MEDICAL BUILDING SUITE 401
Mailing Address - Street 2:CALLE SAN JORGE 252
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00912
Mailing Address - Country:US
Mailing Address - Phone:787-726-1484
Mailing Address - Fax:787-268-0972
Practice Address - Street 1:2140 W 68TH ST STE 200
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1815
Practice Address - Country:US
Practice Address - Phone:305-822-7227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-10
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL154934208800000X, 208800000X
PR21887208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology