Provider Demographics
NPI:1174739387
Name:ROMAN, NITZA
Entity type:Individual
Prefix:
First Name:NITZA
Middle Name:
Last Name:ROMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. EL ROSARIO, CALLE 3 N-10
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-667-8387
Mailing Address - Fax:787-777-2799
Practice Address - Street 1:FARMACIA CENTRO MEDICO
Practice Address - Street 2:BO. MONACILLOS
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00922-2129
Practice Address - Country:US
Practice Address - Phone:787-777-3535
Practice Address - Fax:787-777-2799
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2789183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician