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Jose C Roman Carlo

General Practice

Allopathic & Osteopathic Physicians

55 Nte Medico Iv Ofna 210, Mayaguez, PR 00680

PECOS Enrollment

This provider is enrolled in PECOS as JOSE ROMAN CARLO.

Based on the most recent information from CMS, provider Jose C Roman Carlo is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1295726578
Provider Type
Individual
Full Name
Roman Carlo, Jose C
Title
Dr.
Credential
MD

Gender
Male
Sole Proprietor
Yes
Enumeration Date
11/4/2005
Last Updated
12/20/2010

Contact Information

Practice Location

55 Nte Medico Iv Ofna 210, Mayaguez, PR 00680

(787) 805-5705

(787) 805-4895

Mailing Location

PO Box 3418, Mayaguez, PR 00681-3418

(787) 805-4895

Provider Taxonomies

Code	Description	License
Code 208D00000X Primary	Description General Practice Allopathic & Osteopathic Physicians	License 7202 Puerto Rico

Provider Identifiers

ID	Description	Issuer
ID 062205	Description Other	Issuer CRUZ AZUL
ID 28859	Description Other	Issuer TRIPLE-S

Jose C Roman Carlo

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Illanas Hernandez, Jorge Carlos

Vera Perez, Awilda

Servicios Medicos Serrano, C.S.P.

Jephte Rodriguez Martinez Md P.S.D.

Ribot, Tania Tairy

Cruz-Antequera, William

Vega, Ricardo

Dros- Perez, Jacqueline

Quintana-Velazquez, Mabel

Rodriguez Martinez, Jephte