Provider Demographics
NPI:1942353131
Name:ROMAGUERA, CARLOS R (DO)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:R
Last Name:ROMAGUERA
Suffix:
Gender:M
Credentials:DO
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 41281
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00940-1281
Mailing Address - Country:US
Mailing Address - Phone:787-725-9315
Mailing Address - Fax:787-724-4654
Practice Address - Street 1:150 DE DIEGO AVE
Practice Address - Street 2:SJHC SUITE 404
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:787-725-9315
Practice Address - Fax:787-724-4654
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR116152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist