Provider Demographics
NPI:1760140495
Name:DEL ROSARIO, JOSE
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:DEL ROSARIO
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 42204
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22404-2204
Mailing Address - Country:US
Mailing Address - Phone:540-993-9058
Mailing Address - Fax:
Practice Address - Street 1:904 PRINCESS ANNE ST STE 303-A
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5801
Practice Address - Country:US
Practice Address - Phone:540-993-9058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date: