MEDICARE: DR. SARAH M ACEVEDO-ROMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	227224	MA
2	207W00000X	Ophthalmology Physician	16089	PR

General Provider Information

NPI Number	:	1417990441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH M ACEVEDO-ROMAN MD

Provider Business Mailing Address
First Line	:	35 CALLE JUAN C BORBON
Second Line	:	STE 67-333
City	:	GUAYNABO
State	:	PR
Zip	:	00969-5374
Country	:	US
Telephone Number	:	787-955-5051
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 CALLE JUAN C BORBON
Second Line	:	STE 67-333
City	:	GUAYNABO
State	:	PR
Zip	:	00969-5374
Country	:	US
Telephone Number	:	787-955-5051
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	07/07/2016

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