Healthcare Provider Details

I. General information

NPI: 1851059695
Provider Name (Legal Business Name): DAGMAR LEIAN ROIG ROA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2021
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOSPITAL UPR FEDERICO TRILLA KM 8.3 CALLE 3 AV. 65 DE INFANTERIA
CAROLINA PR
00984
US

IV. Provider business mailing address

125 CALLE ANGELES URB EL PARAISO
ARECIBO PR
00612
US

V. Phone/Fax

Practice location:
  • Phone: 787-757-1800
  • Fax:
Mailing address:
  • Phone: 787-356-5428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number23280
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number23280
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number23280
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: