Provider Demographics
NPI:1023091410
Name:MARCHAN, ROBERTO F (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:F
Last Name:MARCHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 AVE J T PINERO
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-3901
Mailing Address - Country:US
Mailing Address - Phone:787-759-9660
Mailing Address - Fax:787-759-9660
Practice Address - Street 1:271 AVE J T PINERO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927-3901
Practice Address - Country:US
Practice Address - Phone:787-759-9660
Practice Address - Fax:787-759-9660
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR57262085P0229X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D08705Medicare UPIN