MEDICARE: DR. ANGIE M 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	207RC0000X	Cardiovascular Disease Physician	9717	PR

General Provider Information

NPI Number	:	1619943578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGIE M ROSADO MD

Provider Business Mailing Address
First Line	:	PO BOX 801172
Second Line	:
City	:	COTO LAUREL
State	:	PR
Zip	:	00780-1172
Country	:	US
Telephone Number	:	787-812-3792
Fax Number	:	787-812-3794

Provider Business Practice Location Address
First Line	:	2213 PONCE BY PASS
Second Line	:	PARRA MEDICAL INSTITUTE SUITE 708
City	:	PONCE
State	:	PR
Zip	:	00717-1318
Country	:	US
Telephone Number	:	787-812-3792
Fax Number	:	787-812-3794

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

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	08/14/2023

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