Healthcare Provider Details

I. General information

NPI: 1710612296
Provider Name (Legal Business Name): PALOMA ISABEL ROSADO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 01/27/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE SAN GUILLERMO, COOP JARDINES DE SAN IGNACIO 204-A
SAN JUAN PR
00927
US

IV. Provider business mailing address

HACIENDA MARGARITA #45
LUQUILLO PR
00773
US

V. Phone/Fax

Practice location:
  • Phone: 787-662-6537
  • Fax:
Mailing address:
  • Phone: 787-662-6537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number24182
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number24182
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: