MEDICARE: DR. EMMANUEL ROSADO-VALENTIN D.M.D.

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	122300000X	Dentist	2911	PR
2	1223G0001X	General Practice Dentistry	29306	TX

General Provider Information

NPI Number	:	1649523648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMMANUEL ROSADO-VALENTIN D.M.D.

Provider Business Mailing Address
First Line	:	576 AVE ARTERIAL B APT 1808
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-2230
Country	:	US
Telephone Number	:	787-624-9341
Fax Number	:

Provider Business Practice Location Address
First Line	:	576 ARTERIAL B AVE.
Second Line	:	COLISEUM TOWER APT 1808
City	:	SAN JUAN
State	:	PR
Zip	:	00918
Country	:	US
Telephone Number	:	787-616-9537
Fax Number	:

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

Provider Enumeration Date	:	10/16/2012
Last Update Date	:	03/14/2018

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