Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | ME103345 | FL |
NPI | 1225274343 |
---|---|
Provider Name | Dr. Clara Isabel Roman |
First Address | Winter Park, FL 32789-4870 |
Second Address | Casselberry, FL 32707-5398 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2008 |
Last Update Date | 19/05/2010 |