MEDICARE: MARISEL BOSQUES ROSADO MD

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	207RI0200X	Infectious Disease Physician	17066	PR

General Provider Information

NPI Number	:	1548253537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISEL BOSQUES ROSADO MD

Provider Business Mailing Address
First Line	:	1573 CALLE PARANA
Second Line	:	APT 202, PARADISE COURT I
City	:	SAN JUAN
State	:	PR
Zip	:	00926-2982
Country	:	US
Telephone Number	:	787-667-4225
Fax Number	:

Provider Business Practice Location Address
First Line	:	1573 CALLE PARANA
Second Line	:	APT 202, PARADISE COURT I
City	:	SAN JUAN
State	:	PR
Zip	:	00926-2982
Country	:	US
Telephone Number	:	787-667-4225
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	02/07/2021

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