Provider Demographics
NPI:1952009409
Name:ROMAN, ADALBERTO F
Entity Type:Individual
Prefix:
First Name:ADALBERTO
Middle Name:F
Last Name:ROMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 CALLE TITO RODRIGUEZ
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00915-3621
Mailing Address - Country:US
Mailing Address - Phone:939-318-9733
Mailing Address - Fax:
Practice Address - Street 1:1664 CALLE PARANA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-3270
Practice Address - Country:US
Practice Address - Phone:939-314-0447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4417235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist