MEDICARE: DR. JUAN MANUEL ROMAN JR. 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	208D00000X	General Practice Physician	024788	PR

General Provider Information

NPI Number	:	1922680784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUAN MANUEL ROMAN JR. MD

Provider Business Mailing Address
First Line	:	URB ESTANCIA PLAZA 3 G 5
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00961
Country	:	US
Telephone Number	:	939-402-1812
Fax Number	:

Provider Business Practice Location Address
First Line	:	URB ESTANCIA PLAZA 3 G 5
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00961
Country	:	US
Telephone Number	:	939-402-1812
Fax Number	:

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

Provider Enumeration Date	:	04/22/2021
Last Update Date	:	03/08/2026

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