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General NPI Number Information
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NPI Number | 1023182052
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Entity Type | Individual
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Provider Name | NELSON RICARDO ROSARIO-LEON M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 1601 W. ST. MARY'S RD UNIT 2 NORTH ST. MARY'S HOSPITAL
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City | TUCSON
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State | AZ
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Zip | 85795
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Country | US
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Telephone | 520-872-4910
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Fax | 520-872-5495
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Provider Business Mailing Address
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Address Line | 1601 W. ST. MARY'S RD UNIT 2 NORTH ST. MARY'S HOSPITAL
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City | TUCSON
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State | AZ
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Zip | 85795
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Country | US
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Telephone | 520-872-4910
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Fax | 520-872-5495
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 21526
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License Number State | AZ
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