Basic Information
| Provider Information | |||||||||
| NPI: | 1720627318 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROSADO | ||||||||
| FirstName: | JEANAIRA | ||||||||
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| Credential: | PHARM D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 313 COND. VISTAS DEL VALLE | ||||||||
| Address2: | |||||||||
| City: | CAGUAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7874571849 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | HOSPITAL MENONITA CAYEY | ||||||||
| Address2: | ST #14 KM 12 BO. RINCON SECTOR LOMAS | ||||||||
| City: | CAYEY | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7875351530 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/30/2019 | ||||||||
| LastUpdateDate: | 12/30/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/30/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 6282 | PR | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.