MEDICARE: R ROSARIO-MEDINA MD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME67356	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194850990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R ROSARIO-MEDINA MD LLC

Provider Business Mailing Address
First Line	:	1417 N SEMORAN BLVD
Second Line	:	STE 106
City	:	ORLANDO
State	:	FL
Zip	:	32807-3555
Country	:	US
Telephone Number	:	407-382-9703
Fax Number	:	321-766-4566

Provider Business Practice Location Address
First Line	:	1417 N SEMORAN BLVD
Second Line	:	STE 106
City	:	ORLANDO
State	:	FL
Zip	:	32807-3555
Country	:	US
Telephone Number	:	407-382-9703
Fax Number	:	321-766-4566

Authorized Official
Title or Position	:	DOCTOR
Name	:	MR. RALPH ROSARIO-MEDINA
Credential	:	MD
Telephone Number	:	407-382-9703

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	10/26/2007

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Directions to “R ROSARIO-MEDINA MD LLC ” Practice Location

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