Provider Demographics
NPI:1073842258
Name:ROSADO CARMONA, ROSANGELA (MD)
Entity type:Individual
Prefix:
First Name:ROSANGELA
Middle Name:
Last Name:ROSADO CARMONA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 CALLE CANALS
Mailing Address - Street 2:CANALS PLAZA APT. 503
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00907-3003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:251 CALLE CANALS
Practice Address - Street 2:CANALS PLAZA APT. 503
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-3003
Practice Address - Country:US
Practice Address - Phone:787-642-7729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17796208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice