Provider Demographics
NPI:1457319014
Name:FELIU ROSADO, DOMINGO (MD)
Entity Type:Individual
Prefix:DR
First Name:DOMINGO
Middle Name:
Last Name:FELIU 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 7999
Mailing Address - Street 2:STE 343
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-7999
Mailing Address - Country:US
Mailing Address - Phone:787-265-3575
Mailing Address - Fax:787-265-3575
Practice Address - Street 1:60 CALLE POST N
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-6659
Practice Address - Country:US
Practice Address - Phone:787-265-3575
Practice Address - Fax:787-265-3575
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7693207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE83002Medicare UPIN
PR0081124Medicare ID - Type Unspecified