Provider Demographics
NPI:1174738595
Name:ROMAN, NAYDA IVETTE (MD)
Entity type:Individual
Prefix:DR
First Name:NAYDA
Middle Name:IVETTE
Last Name:ROMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 CALLEJON SANTA ANA
Mailing Address - Street 2:INTERIOR #11
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-4757
Mailing Address - Country:US
Mailing Address - Phone:787-881-1057
Mailing Address - Fax:
Practice Address - Street 1:205 CALLEJON SANTA ANA
Practice Address - Street 2:INTERIOR #11
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4757
Practice Address - Country:US
Practice Address - Phone:787-881-1057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10040208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice