Provider Demographics
NPI:1598965683
Name:DE JESUS ROSA FERRE, TIODY (MD)
Entity Type:Individual
Prefix:DR
First Name:TIODY
Middle Name:
Last Name:DE JESUS ROSA FERRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TIODY
Other - Middle Name:
Other - Last Name:DE JESUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:I-58 ROEBELLINI ST
Mailing Address - Street 2:PALMA REAL
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-731-3799
Mailing Address - Fax:
Practice Address - Street 1:I-58 ROEBELLINI ST
Practice Address - Street 2:PALMA REAL
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969
Practice Address - Country:US
Practice Address - Phone:787-731-3799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6810208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice