MEDICARE: DR. PEDRO JUAN ROSADO JR. DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH10163	FL

General Provider Information

NPI Number	:	1396048047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEDRO JUAN ROSADO JR. DC

Provider Business Mailing Address
First Line	:	9906 W LINEBAUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-1858
Country	:	US
Telephone Number	:	813-510-3986
Fax Number	:	813-510-3989

Provider Business Practice Location Address
First Line	:	9906 W LINEBAUGH AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33626-1858
Country	:	US
Telephone Number	:	813-510-3986
Fax Number	:	813-510-3989

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2010
Last Update Date	:	10/21/2015

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