Provider Demographics
NPI:1376744052
Name:ROLDAN, MARIA LUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:LUZ
Last Name:ROLDAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24 BARRANQUITAS
Mailing Address - Street 2:BONNEVILLE HEIGHTS
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:787-645-3823
Mailing Address - Fax:
Practice Address - Street 1:AVE. EL JIBARO, CARR. 172, KM. 13.5
Practice Address - Street 2:BO. BAYAMON INT
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739
Practice Address - Country:US
Practice Address - Phone:787-739-8182
Practice Address - Fax:787-739-8190
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR10851208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics