Provider Demographics
NPI:1790276939
Name:ROSARIO, MARIA DEL CARMEN (AP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9471 BAYMEADOWS RD STE 104
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-7919
Mailing Address - Country:US
Mailing Address - Phone:904-374-8592
Mailing Address - Fax:904-683-9832
Practice Address - Street 1:9471 BAYMEADOWS RD STE 104
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7919
Practice Address - Country:US
Practice Address - Phone:904-374-8592
Practice Address - Fax:904-683-9832
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3511171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty