Provider Demographics
NPI:1154525178
Name:ROSARIO, ROSARIO ISABEL (MD)
Entity type:Individual
Prefix:DR
First Name:ROSARIO
Middle Name:ISABEL
Last Name:ROSARIO
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:CROWN HILLS
Mailing Address - Street 2:1771 CALLE JAJOME
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-6034
Mailing Address - Country:US
Mailing Address - Phone:787-764-0347
Mailing Address - Fax:787-764-0347
Practice Address - Street 1:URB. CROWN HILLS CALLE JAJOME 1771
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-6034
Practice Address - Country:US
Practice Address - Phone:787-764-0347
Practice Address - Fax:787-764-0347
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR31223Medicare UPIN