Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 2602 | PR |
NPI | 1134226954 |
---|---|
Provider Name | Dr. Migdalia Rosario |
First Address | Coto Laurel, PR 00780-2248 |
Second Address | Ponce, PR 00716-3611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |