Provider Demographics
NPI:1518286384
Name:ROSARIO, ANA L
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:L
Last Name:ROSARIO
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:HC 2 BOX 5639
Mailing Address - Street 2:
Mailing Address - City:BAJADERO
Mailing Address - State:PR
Mailing Address - Zip Code:00616-9864
Mailing Address - Country:US
Mailing Address - Phone:939-292-9404
Mailing Address - Fax:
Practice Address - Street 1:CARR 639 KM 4.8
Practice Address - Street 2:
Practice Address - City:SABANA HOYOS
Practice Address - State:PR
Practice Address - Zip Code:00616-9864
Practice Address - Country:US
Practice Address - Phone:939-292-9404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4625183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2211787OtherDRIVER LICENSE