Provider Demographics
NPI:1699816702
Name:ROSARIO, YADIRA (OD)
Entity Type:Individual
Prefix:DR
First Name:YADIRA
Middle Name:
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:BRISAS DE MONTECASINO
Mailing Address - Street 2:570 CANEY
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-0000
Mailing Address - Country:US
Mailing Address - Phone:787-869-2221
Mailing Address - Fax:787-869-0160
Practice Address - Street 1:CARR 152 KM 12.4
Practice Address - Street 2:BO CEDRO ARRIBA
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719
Practice Address - Country:US
Practice Address - Phone:787-869-2221
Practice Address - Fax:787-869-0160
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR555152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist