Provider Demographics
NPI:1013380799
Name:ROSADO, RAFAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:
Last Name:ROSADO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 W SR 436 STE 1070
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2939
Mailing Address - Country:US
Mailing Address - Phone:407-951-8921
Mailing Address - Fax:407-951-8926
Practice Address - Street 1:1052 W SR 436 STE 1070
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2939
Practice Address - Country:US
Practice Address - Phone:407-951-8921
Practice Address - Fax:407-951-8926
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11627111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor