Provider Demographics
NPI:1588650311
Name:ROSADO, ROSANA (MD)
Entity Type:Individual
Prefix:MRS
First Name:ROSANA
Middle Name:
Last Name:ROSADO
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 1:201 AVE. GAUTIER BENITEZ SUITE 034
Mailing Address - Street 2:CONSOLIDATED MEDICAL PLAZA
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-745-0115
Mailing Address - Fax:787-745-0115
Practice Address - Street 1:201 AVE. GAUTIER BENITEZ OFICINA 404
Practice Address - Street 2:CONSOLIDATED MEDICAL PLAZA
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-745-0115
Practice Address - Fax:787-745-0115
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR013626207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H93423Medicare UPIN
21741Medicare ID - Type Unspecified