Provider Demographics
NPI:1326715459
Name:ROSADO, MARILEE (NL)
Entity Type:Individual
Prefix:
First Name:MARILEE
Middle Name:
Last Name:ROSADO
Suffix:
Gender:F
Credentials:NL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ALTURAS DE FLAMBOYAN
Mailing Address - Street 2:II 10 CALLE 2
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-529-1916
Mailing Address - Fax:
Practice Address - Street 1:TORRE SAN FRANCISCO
Practice Address - Street 2:369 CALLE DE DIEGO STE 609
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-0092
Practice Address - Country:US
Practice Address - Phone:787-529-1916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR217175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath