Provider Demographics
NPI:1568565893
Name:FERNANDEZ MEDERO, ROSANGELA L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSANGELA
Middle Name:L
Last Name:FERNANDEZ MEDERO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:HIMA PLAZA I SUITE 714
Mailing Address - Street 2:100 AVE. MUNOZ MARIN
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:939-204-0800
Mailing Address - Fax:939-204-0800
Practice Address - Street 1:100 AVE LUIS MUNOZ MARIN
Practice Address - Street 2:HIMA PLAZA I SUITE 714
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:939-204-0800
Practice Address - Fax:939-204-0818
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR13990207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR13990OtherPR STATE LISCENSE