Provider Demographics
NPI:1508002395
Name:JUSTINIANO ROSARIO, YESENIA E (MD)
Entity type:Individual
Prefix:DR
First Name:YESENIA
Middle Name:E
Last Name:JUSTINIANO ROSARIO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:48 ZEBULAHS TRL
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-5260
Mailing Address - Country:US
Mailing Address - Phone:787-317-7792
Mailing Address - Fax:787-831-3270
Practice Address - Street 1:6 SAINT JOHNS MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5298
Practice Address - Country:US
Practice Address - Phone:904-823-3301
Practice Address - Fax:904-823-3328
Is Sole Proprietor?:No
Enumeration Date:2008-12-28
Last Update Date:2024-11-14
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Provider Licenses
StateLicense IDTaxonomies
PR17382208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice