Provider Demographics
NPI:1851588651
Name:ROMAN-MORALES, IRIS B (MD)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:B
Last Name:ROMAN-MORALES
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 1:14 CALLE PERAL N
Mailing Address - Street 2:SUITE 1-E
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-4861
Mailing Address - Country:US
Mailing Address - Phone:787-833-1060
Mailing Address - Fax:787-265-4025
Practice Address - Street 1:14 CALLE PERAL N
Practice Address - Street 2:SUITE 1-E
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4861
Practice Address - Country:US
Practice Address - Phone:787-833-1060
Practice Address - Fax:787-265-4025
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17966207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology