Provider Demographics
NPI:1851510036
Name:ROMAN, JUAN CARLOS (MD)
Entity Type:Individual
Prefix:
First Name:JUAN
Middle Name:CARLOS
Last Name: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 1:303 CALLE VILLAMIL APT 1201
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-2896
Mailing Address - Country:US
Mailing Address - Phone:787-998-0188
Mailing Address - Fax:787-998-0994
Practice Address - Street 1:ADLER MEDICAL PLAZA
Practice Address - Street 2:576 CALLE CESAR GONZALEZ STE 204
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3757
Practice Address - Country:US
Practice Address - Phone:787-998-0188
Practice Address - Fax:787-998-0994
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14552207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine