Provider Demographics
NPI:1063500593
Name:ROSADO, HECTOR L (MD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:L
Last Name:ROSADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC-4
Mailing Address - Street 2:BOX 8308
Mailing Address - City:JUANA DIAZ
Mailing Address - State:PR
Mailing Address - Zip Code:00795-9606
Mailing Address - Country:US
Mailing Address - Phone:787-298-6481
Mailing Address - Fax:
Practice Address - Street 1:HC 4 BOX 8308
Practice Address - Street 2:
Practice Address - City:JUANA DIAZ
Practice Address - State:PR
Practice Address - Zip Code:00795-9606
Practice Address - Country:US
Practice Address - Phone:787-298-6481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9889207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF87315Medicare UPIN
PR0083728Medicare ID - Type Unspecified