Provider Demographics
NPI:1891508958
Name:MEDELLIN SOLIVAN, ROSANGELA
Entity type:Individual
Prefix:
First Name:ROSANGELA
Middle Name:
Last Name:MEDELLIN SOLIVAN
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 780
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-0780
Mailing Address - Country:US
Mailing Address - Phone:787-245-1836
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 780
Practice Address - Street 2:
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00785-0780
Practice Address - Country:US
Practice Address - Phone:787-245-1836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program