Provider Demographics
NPI:1811392343
Name:ROSADO-JIMENEZ, ADRIANA VIRGINIA (MD)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:VIRGINIA
Last Name:ROSADO-JIMENEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10340 PARK RD STE B
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-8401
Mailing Address - Country:US
Mailing Address - Phone:980-498-3900
Mailing Address - Fax:
Practice Address - Street 1:10340 PARK RD STE B
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8401
Practice Address - Country:US
Practice Address - Phone:646-630-1617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-27
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201602275208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics