Provider Demographics
NPI:1851363493
Name:PLACER ROMAN, CARLOS E (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:E
Last Name:PLACER ROMAN
Suffix:
Gender:M
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:PO BOX 3825
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970-3825
Mailing Address - Country:US
Mailing Address - Phone:787-586-1482
Mailing Address - Fax:787-759-8411
Practice Address - Street 1:CALLE SANTA ROSA 1 SAN JUAN GARDENS
Practice Address - Street 2:
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00926-0926
Practice Address - Country:US
Practice Address - Phone:787-766-0075
Practice Address - Fax:787-759-8411
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR485171100000X
PR6328208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC77573Medicare UPIN