Provider Demographics
NPI:1538106174
Name:ROSARIO, JESUS K (DC)
Entity Type:Individual
Prefix:
First Name:JESUS
Middle Name:K
Last Name:ROSARIO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 NW 25TH ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-1508
Mailing Address - Country:US
Mailing Address - Phone:305-436-1443
Mailing Address - Fax:
Practice Address - Street 1:9300 NW 25 ST.
Practice Address - Street 2:SUITE 106
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172
Practice Address - Country:US
Practice Address - Phone:305-436-1443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8930111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor