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General NPI Number Information
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NPI Number | 1922477421
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY SCIENCE AND AESTHETICS PSC
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 09/15/2015
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Provider Practice Location Address
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Address Line | CARR 891 KM 13 PUEBLO PLAZA DEL CARMEN SUITE 308
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City | COROZAL
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State | PR
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Zip | 00783-0009
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Country | US
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Telephone | 787-365-0315
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Fax | 787-802-2626
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Provider Business Mailing Address
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Address Line | 387 VIA VERSALLES VILLAS REALES
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City | GUAYNABO
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State | PR
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Zip | 00969-5341
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Country | US
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Telephone | 787-365-0315
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Fax | 787-802-2626
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AMARYLIS ROSADO
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Credential | MD
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Telephone | 787-365-0315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 15519
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License Number State | PR
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