| Doctor Name: | CARLOS A FERNANDEZ ROSA |
| NPI Number: | 1124181185 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 5499 |
| Business Practice Address: | Ave Borinquen #2263 Suite #2 Altos San Juan, PR - 00915 |
| Business Phone Number: | 7877287965 |
| Business Fax Number: | 7877262369 |
| Mailing Address: | Po Box 14247, SAN JUAN |
| State: | PR |
| Postal Code: | 009164247 |
| Phone Number: | 7877287965 |
| Fax Number: | 7877262369 |
| NPI Enumeration Date: | 12/19/2006 |
| NPI Last Update Date: | 10/09/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5499 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |