Healthcare Provider Details

I. General information

NPI: 1578494449
Provider Name (Legal Business Name): ADRIAN CARLOS PADIN ROMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 AVE NATIVO ALERS STE 110
AGUADA PR
00602-3418
US

IV. Provider business mailing address

ARENALES ALTOS,TOCONES,CALLE LA FE #210
ISABELA PR
00662
US

V. Phone/Fax

Practice location:
  • Phone: 787-450-5840
  • Fax:
Mailing address:
  • Phone: 787-450-5840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number8232
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: