Healthcare Provider Details

I. General information

NPI: 1306931217
Provider Name (Legal Business Name): CARMEN SUAREZ ROSADO AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1627 AVE JESUS T PINERO
SAN JUAN PR
00920-5407
US

IV. Provider business mailing address

PO BOX 1808
CAYEY PR
00737
US

V. Phone/Fax

Practice location:
  • Phone: 787-792-0760
  • Fax: 787-792-0635
Mailing address:
  • Phone: 787-792-0760
  • Fax: 787-792-0635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355A2700X
TaxonomyAudiology Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number000532
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: