Provider Demographics
NPI:1164029955
Name:ROSA CARTAYA, KLARALIZ (MD)
Entity Type:Individual
Prefix:
First Name:KLARALIZ
Middle Name:
Last Name:ROSA CARTAYA
Suffix:
Gender:F
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:CONDOMINIO ALBORADA
Mailing Address - Street 2:1225 CARR. #2 APT. 2111
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-7305
Mailing Address - Country:US
Mailing Address - Phone:787-938-7837
Mailing Address - Fax:
Practice Address - Street 1:500 CALLE BAEZ
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-5020
Practice Address - Country:US
Practice Address - Phone:787-767-6710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14529104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker