Healthcare Provider Details

I. General information

NPI: 1548306160
Provider Name (Legal Business Name): MR. ARTURO ROSADO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 111 INT 602 KM 0.6 BO ANGELES
UTUADO PR
00641
US

IV. Provider business mailing address

PO BOX 359
ANGELES PR
00611
US

V. Phone/Fax

Practice location:
  • Phone: 787-894-7535
  • Fax: 787-894-7535
Mailing address:
  • Phone: 787-894-7535
  • Fax: 787-894-7535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberONF-1045
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: