Healthcare Provider Details

I. General information

NPI: 1851363493
Provider Name (Legal Business Name): CARLOS E. PLACER ROMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 07/08/2022
Certification Date: 07/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE SANTA ROSA 1 SAN JUAN GARDENS
RIO PIEDRAS PR
00926-0926
US

IV. Provider business mailing address

PO BOX 3825
GUAYNABO PR
00970-3825
US

V. Phone/Fax

Practice location:
  • Phone: 787-766-0075
  • Fax: 787-759-8411
Mailing address:
  • Phone: 787-586-1482
  • Fax: 787-759-8411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number485
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number6328
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: