Provider Demographics
NPI:1225289101
Name:JOUBERT, ROSA M (CNMT,MPH)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:M
Last Name:JOUBERT
Suffix:
Gender:F
Credentials:CNMT,MPH
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Other - Credentials:
Mailing Address - Street 1:STREET 1 A--4 URB. PARAISO DE CAROLINA
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-396-4765
Mailing Address - Fax:787-762-7252
Practice Address - Street 1:10 CALLE CASIA
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921-3200
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR0001192471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine Technology