Provider Demographics
NPI:1629290010
Name:ROSADO, IRIS YOLANDA (MD)
Entity Type:Individual
Prefix:DR
First Name:IRIS
Middle Name:YOLANDA
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:URB SANTA PAULA
Mailing Address - Street 2:CALLE JUAN RAMOS V5
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-789-9623
Mailing Address - Fax:
Practice Address - Street 1:HOSP PSIQUIATRIA DR. RAMON FERNANDEZ MARINA
Practice Address - Street 2:BO MONACILLO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00922
Practice Address - Country:US
Practice Address - Phone:787-766-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12730208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR12730OtherMEDICAL LICENSE