Provider Demographics
NPI:1821219296
Name:AIXA M. ROMAN
Entity Type:Organization
Organization Name:AIXA M. ROMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRADORA
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-785-9282
Mailing Address - Street 1:D27 CALLE PALOMA
Mailing Address - Street 2:URB. LAS GAVIOTAS
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-3471
Mailing Address - Country:US
Mailing Address - Phone:787-646-8145
Mailing Address - Fax:787-785-9290
Practice Address - Street 1:P12 AVE MAGNOLIA
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-2608
Practice Address - Country:US
Practice Address - Phone:787-785-9282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty