Doctor Name: | DR. JOSE VICENTE ROSALES-MEDINA |
NPI Number: | 1326086000 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 13236 |
Business Practice Address: | 419 Ave Hostos Mayaguez, PR - 006801519 |
Business Phone Number: | 7878348800 |
Business Fax Number: | |
Mailing Address: | Po Box 826, BOQUERON |
State: | PR |
Postal Code: | 006220826 |
Phone Number: | 7872267855 |
Fax Number: | 7872542144 |
NPI Enumeration Date: | 06/03/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 13236 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |