1487673307 NPI number — DR. JUAN F PEREZ ROSADO M.D.

Table of content: DR. JUAN F PEREZ ROSADO M.D. (NPI 1487673307)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487673307 NPI number — DR. JUAN F PEREZ ROSADO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PEREZ ROSADO
Provider First Name:
JUAN
Provider Middle Name:
F
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487673307
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/30/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 2188
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOROVIS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00687-2188
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-862-8254
Provider Business Mailing Address Fax Number:
787-862-2309

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BO. FRANQUEZ CARR. 634 KM. 4.9
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOROVIS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00687
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-594-4080
Provider Business Practice Location Address Fax Number:
787-862-2309
Provider Enumeration Date:
07/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  12134 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 32225 . This is a "PROSSAM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 89300 . This is a "TRIPLE S INC. PROVIDER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 061801 . This is a "CRUZ AZUL PROVIDER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1856 . This is a "PREFERRED MEDICARE CHOICE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 212909 . This is a "PREFERRED HEALTH PROVIDER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6740071 . This is a "HUMANA PROVIDER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 7755 . This is a "INTERNATIONAL MEDICAL CAR" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 996216 . This is a "MMM PROVIDER" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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