Provider Demographics
NPI:1669699443
Name:ROSADO, CARMEN
Entity type:Individual
Prefix:PROF
First Name:CARMEN
Middle Name:
Last Name: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:AVE,PERIFERAL A 63
Mailing Address - Street 2:TERRAZAS CUPEY
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-604-6351
Mailing Address - Fax:787-292-7911
Practice Address - Street 1:AVE,PERIFERAL A 63
Practice Address - Street 2:TERRAZAS CUPEY
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-604-6351
Practice Address - Fax:787-292-7911
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2878183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist