Provider Demographics
NPI:1851656938
Name:ROMAN, IRIS VIOLETA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:IRIS
Middle Name:VIOLETA
Last Name:ROMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MONTECASINO 175 CAOBA
Mailing Address - Street 2:
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-251-0287
Mailing Address - Fax:
Practice Address - Street 1:175 CALLE CAOBA
Practice Address - Street 2:URB. MONTECASINO
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-3730
Practice Address - Country:US
Practice Address - Phone:787-251-0287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4456OtherPR PHARMACY LICENSE