Provider Demographics
NPI:1639982028
Name:ROMAN GONZALEZ, AIXA
Entity type:Individual
Prefix:
First Name:AIXA
Middle Name:
Last Name:ROMAN GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 6171
Mailing Address - Street 2:
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659-7247
Mailing Address - Country:US
Mailing Address - Phone:787-933-1100
Mailing Address - Fax:
Practice Address - Street 1:AVENIDA AGUSTIN RAMOS CALERO INTERIOR
Practice Address - Street 2:CARR 112 KM 1.4
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00622-4245
Practice Address - Country:US
Practice Address - Phone:787-933-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical