Provider Demographics
NPI:1386712230
Name:ROMAN GONZALEZ, STEVEN (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:ROMAN GONZALEZ
Suffix:
Gender:
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:PO BOX 1367
Mailing Address - Street 2:
Mailing Address - City:SAN SEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685
Mailing Address - Country:US
Mailing Address - Phone:787-896-6162
Mailing Address - Fax:787-896-6162
Practice Address - Street 1:5 CALLE HOSTOS
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685-2301
Practice Address - Country:US
Practice Address - Phone:787-896-6162
Practice Address - Fax:787-896-6162
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7740207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
1160899OtherACAA
29274OtherTRIPLE S SELECTO
100238WOtherMEDICARE Y MUCHO MAS
21258OtherPREFERRED HEALTH
4307740OtherPLAN SALUD UIA
1234OtherPREFERRED MEDICARE CHOICE
0400238OtherHUMANA
37045OtherPROSAM
27740OtherMCS
29274ROOtherTRIPLE S
0074OtherINTERNATIONAL MEDICAL CAR
2927OtherTRIPLE S OPTIMO
1234OtherPREFERRED MEDICARE CHOICE
PR29274Medicare ID - Type Unspecified
2927OtherTRIPLE S OPTIMO