Provider Demographics
NPI:1558104703
Name:ROSA, KIOMARA (RT)
Entity type:Individual
Prefix:
First Name:KIOMARA
Middle Name:
Last Name:ROSA
Suffix:
Gender:F
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 CALLE CRUZ ROJA
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612-2728
Mailing Address - Country:US
Mailing Address - Phone:787-597-0006
Mailing Address - Fax:
Practice Address - Street 1:1026 CALLE CRUZ ROJA
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-2728
Practice Address - Country:US
Practice Address - Phone:787-597-0006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20472278G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral Care