Provider Demographics
NPI:1942399126
Name:DIAZ ROMERO, PORFIRIO E (MD)
Entity type:Individual
Prefix:DR
First Name:PORFIRIO
Middle Name:E
Last Name:DIAZ ROMERO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:ARBOLES DE MONTEHIEDRA
Mailing Address - Street 2:462 CALLE BAUHINIA
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7162
Mailing Address - Country:US
Mailing Address - Phone:787-536-6710
Mailing Address - Fax:787-957-6696
Practice Address - Street 1:525 AVE FD ROOSEVELT
Practice Address - Street 2:TORRE DE PLAZA SUITE 612
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-8057
Practice Address - Country:US
Practice Address - Phone:787-414-8294
Practice Address - Fax:787-957-6696
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2024-08-05
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Provider Licenses
StateLicense IDTaxonomies
PR12157207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG41187Medicare UPIN