Provider Demographics
NPI:1689325896
Name:ROSADO RIVERA, JOSEAN MANUEL
Entity Type:Individual
Prefix:
First Name:JOSEAN
Middle Name:MANUEL
Last Name:ROSADO RIVERA
Suffix:
Gender:M
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 185
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-0185
Mailing Address - Country:US
Mailing Address - Phone:787-243-4451
Mailing Address - Fax:
Practice Address - Street 1:4 REPTO LA PRADERA
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-3359
Practice Address - Country:US
Practice Address - Phone:787-243-4451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program