Provider Demographics
NPI:1134519275
Name:ROSARIO AMADOR, RAFAEL E (MD)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:E
Last Name:ROSARIO AMADOR
Suffix:
Gender:M
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:URB. QUINTAS REALES
Mailing Address - Street 2:CALLE REY ENRIQUE VIII, R1
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-502-8655
Mailing Address - Fax:
Practice Address - Street 1:PRO-HEALTH CLINICAL SERVICES
Practice Address - Street 2:BAYAMON HEALTH CENTER 2ND FLOOR, CALLE MANUEL ROSSI
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-269-6590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-28
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21336207RN0300X
PR13629I208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice