Provider Demographics
NPI:1417990441
Name:ACEVEDO-ROMAN, SARAH M (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:M
Last Name:ACEVEDO-ROMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CALLE JUAN C BORBON
Mailing Address - Street 2:STE 67-333
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-5374
Mailing Address - Country:US
Mailing Address - Phone:787-955-5051
Mailing Address - Fax:
Practice Address - Street 1:35 CALLE JUAN C BORBON
Practice Address - Street 2:STE 67-333
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-5374
Practice Address - Country:US
Practice Address - Phone:787-955-5051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA227224174400000X
PR16089207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist