Healthcare Provider Details

I. General information

NPI: 1275467862
Provider Name (Legal Business Name): MARIA DEL ROSARIO MONTES CORDERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AV. PEDRO ALBIZU CAMPOS, URB. LA HACIENDA
GUAYAMA PR
00785
US

IV. Provider business mailing address

CARR 184 KM3.5
PATILLAS PR
00723-9639
US

V. Phone/Fax

Practice location:
  • Phone: 787-864-4300
  • Fax:
Mailing address:
  • Phone: 787-527-3488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number001974-P.A.
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: