Provider Demographics
NPI:1023498698
Name:ROSADO, RICHARD (DC)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:ROSADO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:
Other - Last Name:ROSADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:12093 SW 152ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1607
Mailing Address - Country:US
Mailing Address - Phone:786-646-0098
Mailing Address - Fax:305-386-8867
Practice Address - Street 1:12093 SW 152ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1607
Practice Address - Country:US
Practice Address - Phone:786-646-0098
Practice Address - Fax:305-386-8867
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11420111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor