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General NPI Number Information
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NPI Number | 1144534538
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Entity Type | Individual
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Provider Name | LOURDES ROSALES-GUEVARA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 1600 CLIFTON RD NE MS: F-59
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City | ATLANTA
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State | GA
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Zip | 30329-4018
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Country | US
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Telephone | 770-488-0744
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Fax | 770-488-1542
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Provider Business Mailing Address
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Address Line | 28304 PLANTATION DR NE
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City | ATLANTA
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State | GA
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Zip | 30324-2951
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Country | US
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Telephone | 404-272-8902
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Fax |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MA05120800
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License Number State | NJ
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