Provider Demographics
NPI:1376711192
Name:JIMENEZ-ROSADO, JOSE FRANCISCO (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:FRANCISCO
Last Name:JIMENEZ-ROSADO
Suffix:
Gender:M
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:PO BOX 892
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613-0892
Mailing Address - Country:US
Mailing Address - Phone:787-404-6871
Mailing Address - Fax:
Practice Address - Street 1:PAVIA HOSPITAL
Practice Address - Street 2:1462 CALLE PROF AUGUSTO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00910
Practice Address - Country:US
Practice Address - Phone:787-641-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17031208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR002-7839OtherSSS
PR002-7839OtherSSS