Provider Demographics
NPI:1700896917
Name:ROSARIO, ROXANA (DC)
Entity Type:Individual
Prefix:DR
First Name:ROXANA
Middle Name:
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270370
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00928-3170
Mailing Address - Country:US
Mailing Address - Phone:787-603-5858
Mailing Address - Fax:787-296-3226
Practice Address - Street 1:508 AVE HOSTOS
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3231
Practice Address - Country:US
Practice Address - Phone:787-603-5858
Practice Address - Fax:787-296-3226
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000331111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR60089OtherPROVIDER NUMBER WITH SSS
PR995378OtherPROVIDER NUMBER MMM
PR9160009OtherPROVIDER NUMBER HUMANA
PR03617OtherPROVIDER # AM. HEALTH
PR60089OtherPROVIDER NUMBER WITH SSS
PR995378OtherPROVIDER NUMBER MMM