# SAMARI ROMAN GANDULLA & ASOCIADOS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164835625
- **Authorized official:** SAMARI ROMAN GANDULLA M.D. (PRESIDENTA)
- **Authorized official phone:** (787) 649-7212

## Contact information

- **Practice address:** 1452 AVE ASHFORD, 408 ADA LIGIA, SAN JUAN, PR 00907-1581
- **Practice address phone:** (787) 509-7212
- **Mailing address:** 1452 AVE ASHFORD, 408 ADA LIGIA, SAN JUAN, PR 00907-1581
- **Mailing address phone:** (787) 509-7212

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |
| 261QS1000X | Student Health Clinic/Center | — | PR | — |

## Other

- **Enumeration date:** 06/03/2014
- **Last updated:** 06/03/2014