Provider Demographics
NPI:1649357641
Name:ROMAN, FELIX A I (MD)
Entity type:Individual
Prefix:DR
First Name:FELIX
Middle Name:A
Last Name:ROMAN
Suffix:I
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4X6 AVE CARLOS JAVIER ANDALUZ
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-2967
Mailing Address - Country:US
Mailing Address - Phone:787-787-5338
Mailing Address - Fax:787-787-5338
Practice Address - Street 1:4X6 AVE CARLOS JAVIER ANDALUZ
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-2967
Practice Address - Country:US
Practice Address - Phone:787-787-5338
Practice Address - Fax:787-787-5338
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4112208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE43188Medicare UPIN