Provider Demographics
NPI:1346680691
Name:DEL ROSARIO, JONATHAN RICHARD (DO)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:RICHARD
Last Name:DEL ROSARIO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 S TREASURE DR
Mailing Address - Street 2:503
Mailing Address - City:NORTH BAY VILLAGE
Mailing Address - State:FL
Mailing Address - Zip Code:33141-4390
Mailing Address - Country:US
Mailing Address - Phone:917-331-6538
Mailing Address - Fax:
Practice Address - Street 1:1801 S TREASURE DR
Practice Address - Street 2:503
Practice Address - City:NORTH BAY VILLAGE
Practice Address - State:FL
Practice Address - Zip Code:33141-4390
Practice Address - Country:US
Practice Address - Phone:917-331-6538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY05456207P00000X
FLOS12819207P00000X
390200000X
NY279159-1207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program