Provider Demographics
NPI:1649993171
Name:ROSA FUERTES, JORGE EMANUEL (MD, PA)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:EMANUEL
Last Name:ROSA FUERTES
Suffix:
Gender:M
Credentials:MD, PA
Other - Prefix:
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Mailing Address - Street 1:HCDA LA MATILDE
Mailing Address - Street 2:5184 CALLE TRAPICHE
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728-2426
Mailing Address - Country:US
Mailing Address - Phone:787-923-2484
Mailing Address - Fax:
Practice Address - Street 1:HCDA LA MATILDE
Practice Address - Street 2:5184 CALLE TRAPICHE
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728-2426
Practice Address - Country:US
Practice Address - Phone:787-923-2484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR956PA363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical