MEDICARE: RUBY YANINA ROSARIO

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	183700000X	Pharmacy Technician	6093	PR

General Provider Information

NPI Number	:	1619175437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUBY YANINA ROSARIO

Provider Business Mailing Address
First Line	:	CALLE FRANCISCO CANALES ROMAN #19
Second Line	:
City	:	TOA BAJA
State	:	PR
Zip	:	00949
Country	:	US
Telephone Number	:	787-794-2473
Fax Number	:

Provider Business Practice Location Address
First Line	:	B35 CALLE 6
Second Line	:	URN SAN FERNANDO
City	:	TOA ALTA
State	:	PR
Zip	:	00953-2205
Country	:	US
Telephone Number	:	787-870-2935
Fax Number	:

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

Provider Enumeration Date	:	07/03/2007
Last Update Date	:	07/08/2007

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