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General NPI Number Information
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NPI Number | 1346654811
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Entity Type | Organization
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Legal Business Name | DR. ROMAN DIAZ HEMATOLOGY AND ONCOLOGY SERVICES, PSC
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 06/12/2014
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Provider Practice Location Address
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Address Line | KM 39.5 STREET #2 SUITE 108 HOSPITAL WILMA VAZQUEZ
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-858-6310
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Fax |
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Provider Business Mailing Address
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Address Line | CARR #2 KM 39.5 SUITE 108 HOSPITAL WILMA VAZQUEZ
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-858-6310
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAIME LUIS ROMAN-DIAZ
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Credential | MD
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Telephone | 787-858-6310
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 17027
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License Number State | PR
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