Provider Demographics
NPI:1619943578
Name:ROSADO, ANGIE M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGIE
Middle Name:M
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:PO BOX 801172
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1172
Mailing Address - Country:US
Mailing Address - Phone:787-812-3792
Mailing Address - Fax:787-812-3794
Practice Address - Street 1:2213 PONCE BY PASS
Practice Address - Street 2:PARRA MEDICAL INSTITUTE SUITE 708
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1318
Practice Address - Country:US
Practice Address - Phone:787-812-3792
Practice Address - Fax:787-812-3794
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9717207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
F87151Medicare UPIN
0083167Medicare ID - Type Unspecified