Provider Demographics
NPI:1780337253
Name:GONZALEZ-ROMAN, MARIBEL (SLP)
Entity type:Individual
Prefix:DR
First Name:MARIBEL
Middle Name:
Last Name:GONZALEZ-ROMAN
Suffix:
Gender:F
Credentials:SLP
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 1807
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777-1807
Mailing Address - Country:US
Mailing Address - Phone:787-568-8583
Mailing Address - Fax:
Practice Address - Street 1:RECINTO DE CIENCIAS MEDICAS
Practice Address - Street 2:ESCUELA DE PROFESIONALES DE LA SAUD
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936
Practice Address - Country:US
Practice Address - Phone:877-758-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0540235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist