Provider Demographics
NPI:1821339227
Name:ROSARIO-SOTO, GENOVES
Entity Type:Individual
Prefix:DR
First Name:GENOVES
Middle Name:
Last Name:ROSARIO-SOTO
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:M47 CALLE 9
Mailing Address - Street 2:ALTURAS
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-2753
Mailing Address - Country:US
Mailing Address - Phone:787-202-4260
Mailing Address - Fax:787-840-8798
Practice Address - Street 1:M47 CALLE 9
Practice Address - Street 2:ALTURAS
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-2753
Practice Address - Country:US
Practice Address - Phone:787-202-4260
Practice Address - Fax:787-840-8798
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-09
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist