Provider Demographics
NPI:1629622659
Name:ROSADO, ARELYS
Entity Type:Individual
Prefix:
First Name:ARELYS
Middle Name:
Last Name:ROSADO
Suffix:
Gender:F
Credentials:
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 9023547
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00902-3547
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:MCS PLAZA SUITE 105
Practice Address - Street 2:255 AVE PONCE DE LEON
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00916-1919
Practice Address - Country:US
Practice Address - Phone:787-758-2500
Practice Address - Fax:787-622-2429
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4643183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist