Provider Demographics
NPI:1538142211
Name:AMADEO-ROSARIO, RITA LUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:LUZ
Last Name:AMADEO-ROSARIO
Suffix:
Gender:F
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:G2 CALLE 1
Mailing Address - Street 2:MANSIONES DE GARDEN HILLS
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-2711
Mailing Address - Country:US
Mailing Address - Phone:787-793-0187
Mailing Address - Fax:
Practice Address - Street 1:G2 CALLE 1
Practice Address - Street 2:MANSIONES DE GARDEN HILLS
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966-2711
Practice Address - Country:US
Practice Address - Phone:787-793-0187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3864208100000X
NY116129208100000X
GA27482208100000X
MDD40759208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR95624Medicare ID - Type Unspecified
PRE31137Medicare UPIN