Healthcare Provider Details

I. General information

NPI: 1659227999
Provider Name (Legal Business Name): ROSARIO SOSA-CORTEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 JEFFERSON AVE SE
GRAND RAPIDS MI
49503-4324
US

IV. Provider business mailing address

221 BARNETT ST NE
GRAND RAPIDS MI
49503-1067
US

V. Phone/Fax

Practice location:
  • Phone: 616-288-4569
  • Fax:
Mailing address:
  • Phone: 616-427-2353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number175319663
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: