Provider Demographics
NPI:1730382532
Name:ROMERO-DIAZ, MARIELA (MD)
Entity type:Individual
Prefix:
First Name:MARIELA
Middle Name:
Last Name:ROMERO-DIAZ
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 1:24 CALLE FANTASIA
Mailing Address - Street 2:URB. LOS SUENOS
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-7803
Mailing Address - Country:US
Mailing Address - Phone:787-645-3220
Mailing Address - Fax:
Practice Address - Street 1:HOSPITAL RYDER MEMORIAL INCS
Practice Address - Street 2:AVE. FONT MARTELO
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-852-0768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17162207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine