Provider Demographics
NPI:1386609741
Name:ROMAN MORALES, REINALDO L (MD)
Entity type:Individual
Prefix:DR
First Name:REINALDO
Middle Name:L
Last Name:ROMAN MORALES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1173 CALLE MAXIMO ALOMAR
Mailing Address - Street 2:URB. SAN AGUSTIN
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00923-3231
Mailing Address - Country:US
Mailing Address - Phone:787-751-7791
Mailing Address - Fax:787-767-3261
Practice Address - Street 1:1173 CALLE MAXIMO ALOMAR
Practice Address - Street 2:URB. SAN AGUSTIN
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-3231
Practice Address - Country:US
Practice Address - Phone:787-751-7791
Practice Address - Fax:787-767-3261
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2011-03-08
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Provider Licenses
StateLicense IDTaxonomies
PR4131207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR95744OtherSSS
PR600547OtherMEDICARE Y MUCHO MAS
PR63621OtherCRUZ AZUL
PR95744OtherTRIPLE C
PR95744OtherSSS
PR0095744Medicare PIN