Provider Demographics
NPI:1346654811
Name:DR. ROMAN DIAZ HEMATOLOGY AND ONCOLOGY SERVICES, PSC
Entity Type:Organization
Organization Name:DR. ROMAN DIAZ HEMATOLOGY AND ONCOLOGY SERVICES, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:ROMAN-DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-858-6310
Mailing Address - Street 1:CARR #2 KM 39.5 SUITE 108
Mailing Address - Street 2:HOSPITAL WILMA VAZQUEZ
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-858-6310
Mailing Address - Fax:
Practice Address - Street 1:KM 39.5 STREET #2 SUITE 108
Practice Address - Street 2:HOSPITAL WILMA VAZQUEZ
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693
Practice Address - Country:US
Practice Address - Phone:787-858-6310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17027261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty