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NPI Code Detail

MEDICARE: DR. ROSE EILEEN JUSTINIANO MD

MEDICARE:  DR. ROSE EILEEN JUSTINIANO  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
1208D00000XGeneral Practice Physician15,674PR

General Provider Information

NPI Number : 1558341487
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROSE EILEEN JUSTINIANO MD
Provider Business Mailing Address
First Line : 19 CALLE BIMINI
Second Line :
City : MAYAGUEZ
State : PR
Zip : 00680-5120
Country : US
Telephone Number : 787-823-0110
Fax Number :
Provider Business Practice Location Address
First Line : 67 CALLE 65 INFANTERIA
Second Line : SUITE A-109
City : ANASCO
State : PR
Zip : 00610-2909
Country : US
Telephone Number : 787-826-2145
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 07/08/2007

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Directions to “ DR. ROSE EILEEN JUSTINIANO MD” Practice Location

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