Provider Demographics
NPI:1669661930
Name:ROSADO, WALESKA (PT)
Entity Type:Individual
Prefix:MRS
First Name:WALESKA
Middle Name:
Last Name:ROSADO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BAYAMON MEDICAL PLAZA
Mailing Address - Street 2:SUIT 106
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-7203
Mailing Address - Country:US
Mailing Address - Phone:787-785-8666
Mailing Address - Fax:787-798-5700
Practice Address - Street 1:BAYAMON MEDICAL PLZ
Practice Address - Street 2:1845 CARR #2 SUIT # 106
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-7200
Practice Address - Country:US
Practice Address - Phone:787-785-8666
Practice Address - Fax:787-798-5700
Is Sole Proprietor?:No
Enumeration Date:2007-10-23
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1049174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR1853176OtherDRIVER LICENCE
PR1049OtherPHYSICAL THERAPY LICENCE