| Doctor Name: | SANDRA I ROSADO MEDINA |
| NPI Number: | 1366639205 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 16900 |
| Business Practice Address: | Carr 861 Bo. Pinas Sector El Siete Toa Alta, PR - 009538528 |
| Business Phone Number: | 7873999368 |
| Business Fax Number: | |
| Mailing Address: | 1009 Calle Reyna Mora, Hacienda El Pilar TOA ALTA |
| State: | PR |
| Postal Code: | 009539420 |
| Phone Number: | 7873999368 |
| Fax Number: | |
| NPI Enumeration Date: | 09/25/2007 |
| NPI Last Update Date: | 03/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 16900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |