Basic Information
| Provider Information | |||||||||
| NPI: | 1952845802 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSARIO | ||||||||
| FirstName: | ROSA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 43001 | ||||||||
| Address2: | |||||||||
| City: | RIO GRANDE | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007456600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7879426636 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 202 AVE GAUTIER BENITEZ | ||||||||
| Address2: | CONSOLIDATED MALL LOCAL B-5 | ||||||||
| City: | CAGUAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007250000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877040705 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/12/2016 | ||||||||
| LastUpdateDate: | 12/12/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WG0000X | 13457 | PR | Y | Nursing Service Providers | Registered Nurse | General Practice |
No ID Information.