Provider Demographics
NPI:1659497402
Name:ROSADO IRIZARRY, MILAGROS (DC)
Entity Type:Individual
Prefix:DR
First Name:MILAGROS
Middle Name:
Last Name:ROSADO IRIZARRY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86-B AVE. UNIVERSIDAD INTERAMERICANA
Mailing Address - Street 2:
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683-4342
Mailing Address - Country:US
Mailing Address - Phone:787-538-3950
Mailing Address - Fax:
Practice Address - Street 1:SUITE 86-B AVE. UNIVERSIDAD INTERAMERICANA
Practice Address - Street 2:
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683-4342
Practice Address - Country:US
Practice Address - Phone:787-538-3950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006594111N00000X
FLCH 8967111N00000X
PR000463111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRGW795ZMedicare UPIN