Provider Demographics
NPI:1336195205
Name:ROSARIO, CARLA MICHELLE (MD)
Entity Type:Individual
Prefix:MISS
First Name:CARLA
Middle Name:MICHELLE
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:D STREET H5
Mailing Address - Street 2:URB TORREMOLINOS ESTE
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969
Mailing Address - Country:US
Mailing Address - Phone:787-237-5405
Mailing Address - Fax:787-790-8872
Practice Address - Street 1:SERGIO CUEVAS BUSTAMANTE ST
Practice Address - Street 2:# 523 URB. PARQUE CENTRAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-294-9399
Practice Address - Fax:787-294-9978
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2012-04-12
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Provider Licenses
StateLicense IDTaxonomies
PR15569208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice