Provider Demographics
NPI:1245290493
Name:ROSA, FELIX J (MD)
Entity type:Individual
Prefix:DR
First Name:FELIX
Middle Name:J
Last Name:ROSA
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 1:344 VIA CANAVERAL
Mailing Address - Street 2:HAC. SAN JOSE
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-3039
Mailing Address - Country:US
Mailing Address - Phone:787-637-9929
Mailing Address - Fax:
Practice Address - Street 1:371 AVE DE DIEGO
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-3002
Practice Address - Country:US
Practice Address - Phone:787-754-4244
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8683207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC82680Medicare UPIN
PR80164Medicare ID - Type Unspecified