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General NPI Number Information
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NPI Number | 1184848681
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Entity Type | Individual
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Provider Name | ROSALEE MATIAS PT
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Gender | Female
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | CARR 862 KM 2 HM 8 SECT LO FRAILES
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City | BAYAMON
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State | PR
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Zip | 00958
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Country | US
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Telephone | 787-799-3391
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3576 BAYAMON GARDENS
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City | BAYAMON
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State | PR
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Zip | 00958-0576
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Country | US
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Telephone | 787-799-3391
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 5273
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License Number State | PR
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