Provider Demographics
NPI:1508095043
Name:ROSARIO MEDICAL SERVICES CSP
Entity Type:Organization
Organization Name:ROSARIO MEDICAL SERVICES CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-525-4034
Mailing Address - Street 1:PO BOX 826
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-0826
Mailing Address - Country:US
Mailing Address - Phone:787-899-2865
Mailing Address - Fax:787-808-3983
Practice Address - Street 1:CARRETERA 116 KM 2.0
Practice Address - Street 2:BO. SABANA YEGUA, SECTOR CANIRA 37
Practice Address - City:LAJAS
Practice Address - State:PR
Practice Address - Zip Code:00667-2061
Practice Address - Country:US
Practice Address - Phone:787-899-2865
Practice Address - Fax:787-808-3983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14435261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service