Healthcare Provider Details

I. General information

NPI: 1134226954
Provider Name (Legal Business Name): MIGDALIA ROSARIO DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2431 EDIFICIO PORRATA PILA SUITE 103 AVE EDNITA NAZARIO
PONC PR
00717
US

IV. Provider business mailing address

1414 BULEVAR SANTIAGO
COTO LAUREL PR
00780-2248
US

V. Phone/Fax

Practice location:
  • Phone: 787-284-5154
  • Fax:
Mailing address:
  • Phone: 787-843-5618
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number2602
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: