Healthcare Provider Details

I. General information

NPI: 1528607488
Provider Name (Legal Business Name): ADRIANA M ROIG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/24/2019
Last Update Date: 12/24/2019
Certification Date: 12/24/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 AVE LOMAS VERDES
SAN JUAN PR
00927-6638
US

IV. Provider business mailing address

310 AVE LOMAS VERDES
SAN JUAN PR
00927-6638
US

V. Phone/Fax

Practice location:
  • Phone: 787-740-7000
  • Fax: 787-789-3232
Mailing address:
  • Phone: 787-740-7000
  • Fax: 787-789-3232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1890
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: