Provider Demographics
NPI:1053089631
Name:ROSADO BAEZ, ALEXSANDRA
Entity Type:Individual
Prefix:DR
First Name:ALEXSANDRA
Middle Name:
Last Name:ROSADO BAEZ
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:URB. SANTA MARTA CALLE G H-3
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-0047
Mailing Address - Country:US
Mailing Address - Phone:787-396-8990
Mailing Address - Fax:
Practice Address - Street 1:URB. SANTA MARTA CALLE G H-3 SAN GERMAN
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-396-8990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22453208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice