Provider Demographics
NPI:1396989190
Name:GARCIA-ROSADO, LIZA
Entity type:Individual
Prefix:
First Name:LIZA
Middle Name:
Last Name:GARCIA-ROSADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 46 BOX 5800
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-9621
Mailing Address - Country:US
Mailing Address - Phone:787-596-7547
Mailing Address - Fax:
Practice Address - Street 1:AVE. PRINCIPAL N 15
Practice Address - Street 2:CALLE 18 SUITE 1
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953
Practice Address - Country:US
Practice Address - Phone:787-797-7615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7072183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician