Provider Demographics
NPI:1215163589
Name:BOBE ROSARIO, EMMANUEL (MD)
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:
Last Name:BOBE ROSARIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1543 CALLE PORTOFINO
Mailing Address - Street 2:URBANIZACION FUENTEBELLA
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-449-3183
Mailing Address - Fax:
Practice Address - Street 1:1543 CALLE PORTOFINO
Practice Address - Street 2:URBANIZACION FUENTEBELLA
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953
Practice Address - Country:US
Practice Address - Phone:787-449-3183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17403208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice