MEDICARE: DR. JOSE OSCAR ROSADO

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	1442	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	067215	OTHER	PR	CRUZ AZUL
2	4-1551	OTHER	PR	TRIPLE S
3	9180429	OTHER	PR	HUMANA
4	600731	OTHER	PR	MMM

General Provider Information

NPI Number	:	1740248954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE OSCAR ROSADO

Provider Business Mailing Address
First Line	:	735 PONCE DE LEON AVE
Second Line	:	SUITE 1514 TORRE DE OFICINAS MEDICAS AUXILIO MUTUO
City	:	SAN JUAN
State	:	PR
Zip	:	00917-5022
Country	:	US
Telephone Number	:	787-250-6400
Fax Number	:	787-250-6443

Provider Business Practice Location Address
First Line	:	735 PONCE DE LEON AVE
Second Line	:	SUITE 1514 TORRE DE OFICINAS MEDICAS AUXILIO MUTUO
City	:	SAN JUAN
State	:	PR
Zip	:	00917-5022
Country	:	US
Telephone Number	:	787-250-6400
Fax Number	:	787-250-6443

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. JOSE OSCAR ROSADO ” Practice Location

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