Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME53996 | FL |
N | 111NI0900X | Internist | ME53996 | FL |
Y | 207RG0100X | Gastroenterologist | ME53996 | FL |
NPI | 1023127909 |
---|---|
Provider Name | Angel M Rosario |
First Address | Tampa, FL 33614-3972 |
Second Address | Tampa, FL 33614-3972 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 31/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
058398700 | (05) | FL |
E83285 | (02) | FL |