Provider Demographics
NPI:1275729725
Name:ROSADO, BETZAIDA (MD)
Entity Type:Individual
Prefix:
First Name:BETZAIDA
Middle Name:
Last Name:ROSADO
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 1:420 CALLE FLAMBOYAN
Mailing Address - Street 2:URB. LOS SAUCES
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-4908
Mailing Address - Country:US
Mailing Address - Phone:787-850-5843
Mailing Address - Fax:
Practice Address - Street 1:420 CALLE FLAMBOYAN
Practice Address - Street 2:URB. LOS SAUCES
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-4908
Practice Address - Country:US
Practice Address - Phone:787-850-5843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11320208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice