Doctor Name: | DR. ANGEL LUIS ROSA |
NPI Number: | 1770592529 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 006359 |
Business Practice Address: | #57 Calle Isabel Andreu De Aguilar-este Fajardo, PR - 007384806 |
Business Phone Number: | 7878636465 |
Business Fax Number: | 7878606826 |
Mailing Address: | 57 Isabel Andreu-este, FAJARDO |
State: | PR |
Postal Code: | 007384806 |
Phone Number: | 7878636465 |
Fax Number: | 7878606826 |
NPI Enumeration Date: | 08/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 006359 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |