Provider Demographics
NPI:1215123161
Name:OSORIO MANOTAS, ROBERTO ENRIQUE (MD)
Entity type:Individual
Prefix:MR
First Name:ROBERTO
Middle Name:ENRIQUE
Last Name:OSORIO MANOTAS
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:PASEO SAN PABLO #100 EDIF ARTURO CADILLA SUITE 501
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:787-780-4297
Mailing Address - Fax:787-798-3110
Practice Address - Street 1:PASEO SAN PABLO #100 EDIF ARTURO CADILLA SUITE 501
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-780-4297
Practice Address - Fax:787-798-3110
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20939207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology