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General NPI Number Information
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NPI Number | 1144436841
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Entity Type | Individual
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Provider Name | ELIZABETH ROMAN MD
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 63 AVE MUNOZ RIVERA E
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City | CAMUY
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State | PR
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Zip | 00627-2630
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Country | US
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Telephone | 787-898-2660
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Fax | 787-262-1210
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Provider Business Mailing Address
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Address Line | PO BOX 35
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City | CAMUY
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State | PR
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Zip | 00627-0035
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Country | US
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Telephone | 787-613-2984
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Fax | 787-262-1210
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11144
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License Number State | PR
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