Provider Demographics
NPI:1336628916
Name:RIOS ROMAN, ALVIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:
Last Name:RIOS ROMAN
Suffix:
Gender:M
Credentials:PSYD
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 52
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:PR
Mailing Address - Zip Code:00786-0052
Mailing Address - Country:US
Mailing Address - Phone:787-607-3063
Mailing Address - Fax:
Practice Address - Street 1:BARRIO ARENA SECTOR MONTICELLO
Practice Address - Street 2:CARR 734 KM 3 HM 4 INT
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739
Practice Address - Country:US
Practice Address - Phone:787-607-3063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1840103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical