Provider Demographics
NPI:1467608539
Name:ROSADO RODRIGUEZ, BRENDA
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:
Last Name:ROSADO RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 CALLE DR GONZALEZ
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-2633
Mailing Address - Country:US
Mailing Address - Phone:787-872-5565
Mailing Address - Fax:787-872-4111
Practice Address - Street 1:133 CALLE DR GONZALEZ
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-2633
Practice Address - Country:US
Practice Address - Phone:787-872-5565
Practice Address - Fax:787-872-4111
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1019225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist