Provider Demographics
NPI:1053080507
Name:ROSARIO, ELIAS D (ND)
Entity Type:Individual
Prefix:
First Name:ELIAS
Middle Name:D
Last Name:ROSARIO
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5451 BROADVIEW RD STE 3
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44134-7809
Mailing Address - Country:US
Mailing Address - Phone:216-290-9424
Mailing Address - Fax:
Practice Address - Street 1:5451 BROADVIEW RD STE 3
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44134-7809
Practice Address - Country:US
Practice Address - Phone:216-290-9424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty