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General NPI Number Information
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NPI Number | 1306176698
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Entity Type | Individual
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Provider Name | YANITZA ROMAN 004889
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Gender | Female
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Dates
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Enumeration Date | 01/08/2010
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | CARR 493 KM 0.5 BO.CARRIZALES MEDICAL PROFESSIONAL OFFICE PLAZA SUITE 111
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City | HATILLO
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State | PR
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Zip | 00659
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Country | US
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Telephone | 787-243-6850
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 141133
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City | ARECIBO
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State | PR
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Zip | 00614-1133
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Country | US
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Telephone | 787-243-6850
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 004889
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License Number State | PR
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