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General NPI Number Information
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NPI Number | 1447369558
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Entity Type | Individual
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Provider Name | REYNALDO S. DELA ROSA MD
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 1202 S TYLER ST
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City | COVINGTON
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State | LA
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Zip | 70433-2330
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Country | US
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Telephone | 985-898-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 1514 JEFFERSON HWY
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City | NEW ORLEANS
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State | LA
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Zip | 70121-2429
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Country | US
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Telephone | 504-703-8433
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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 | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 01060859
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 202653
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License Number State | LA
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