MEDICARE: DENIZ E GARCIA-DE LA ROSA 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	207RN0300X	Nephrology Physician	13461	PR

General Provider Information

NPI Number	:	1811992712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENIZ E GARCIA-DE LA ROSA MD

Provider Business Mailing Address
First Line	:	PO BOX 30018
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00929-1018
Country	:	US
Telephone Number	:	787-781-8506
Fax Number	:

Provider Business Practice Location Address
First Line	:	SUITE 205 CARR.21 #1785 LAS LOMAS
Second Line	:	HOSPITAL METROPOLITANO
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00921
Country	:	US
Telephone Number	:	787-781-8506
Fax Number	:	787-749-0392

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	01/18/2008

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