Individual provider · Type 1 NPI

Johan Mennig San Roman, PA-C

Medical Physician Assistant · Homestead, FL

NPI number 1023290269 Active

Practice location

975 Baptist Way
Homestead, FL 33033-7600

Call (305) 793-4706 Map

Mailing address

6634 SW 114th Pl, Unit A
Miami, FL 33173-1783

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA3409 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1023290269

Johan Mennig San Roman, PA-C's National Provider Identifier is 1023290269, issued on Nov 29, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Homestead, FL. The record was last updated on Nov 29, 2007.