Provider Demographics
NPI:1194735050
Name:ROSADO GALARZA, JULIO R (MD)
Entity type:Individual
Prefix:DR
First Name:JULIO
Middle Name:R
Last Name:ROSADO GALARZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 STREET A 12
Mailing Address - Street 2:URB EL MIRADOR DE CUPEY
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:939-640-1702
Mailing Address - Fax:
Practice Address - Street 1:AVE GAUTIER BENITEZ ANEXO B-5
Practice Address - Street 2:CONSOLIDATED MALL
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-704-0705
Practice Address - Fax:787-704-0870
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR100452084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0082347Medicare ID - Type UnspecifiedMEDICARE PART B PROVIDER