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General NPI Number Information
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NPI Number | 1427024389
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Entity Type | Individual
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Provider Name | RICARDO ROSARIO-MENDOZA M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/28/2006
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Last Update Date | 06/11/2009
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Provider Practice Location Address
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Address Line | 552 CALLE CESAR GONZALEZ EXT. ROOSEVELT
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City | SAN JUAN
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State | PR
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Zip | 00918-2604
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Country | US
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Telephone | 787-753-1510
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Fax | 787-753-6585
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Provider Business Mailing Address
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Address Line | EL SENORIAL MAIL STATION BOX 452 WINSTON CHURCHILL AVE. 138 CROWN HILLS
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City | SAN JUAN
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State | PR
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Zip | 00926-6023
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Country | US
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Telephone | 787-767-2038
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Fax | 787-758-8096
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 4879
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License Number State | PR
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