Provider Demographics
NPI:1346072311
Name:RODRIGUEZ RABELO, ROSANA
Entity type:Individual
Prefix:
First Name:ROSANA
Middle Name:
Last Name:RODRIGUEZ RABELO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1234
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:PR
Mailing Address - Zip Code:00751-1234
Mailing Address - Country:US
Mailing Address - Phone:787-618-1488
Mailing Address - Fax:
Practice Address - Street 1:174 CALLE LUIS BARRERAS S
Practice Address - Street 2:
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736-4615
Practice Address - Country:US
Practice Address - Phone:787-738-3011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-17
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR005191363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily