Healthcare Provider Details

I. General information

NPI: 1629558895
Provider Name (Legal Business Name): ALEXANDRA ROSARIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2018
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 TORRE SAN CRISTOBAL STE 302
COTO LAUREL PR
00780-2849
US

IV. Provider business mailing address

343 ESTANCIAS DEL GOLF CALLE JUAN H CINTRON
PONCE PR
00730
US

V. Phone/Fax

Practice location:
  • Phone: 787-259-1934
  • Fax: 787-840-7734
Mailing address:
  • Phone: 787-379-4648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number22741
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: