Provider Demographics
NPI:1154317568
Name:ROSADO, LILIANNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:LILIANNE
Middle Name:
Last Name:ROSADO
Suffix:
Gender:F
Credentials:DMD
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 1679
Mailing Address - Street 2:
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00785-1679
Mailing Address - Country:US
Mailing Address - Phone:787-839-8220
Mailing Address - Fax:787-839-3135
Practice Address - Street 1:23 GUILERMO RIEFFHOL STREET
Practice Address - Street 2:
Practice Address - City:PATILAS
Practice Address - State:PR
Practice Address - Zip Code:00723
Practice Address - Country:US
Practice Address - Phone:787-839-8220
Practice Address - Fax:787-839-3135
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice