Provider Demographics
NPI:1417433343
Name:ROSARIO, JEDSIA N (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:MRS
First Name:JEDSIA
Middle Name:N
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 69 BOX 15544
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-9872
Mailing Address - Country:US
Mailing Address - Phone:787-780-7383
Mailing Address - Fax:787-780-7389
Practice Address - Street 1:CARR 174 KM 10.2 SECT LA MORENITA
Practice Address - Street 2:BO GUARAGUAO
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-780-7381
Practice Address - Fax:787-780-7389
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR11394OtherSTATE LICENCE