Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 8219 | PR |
NPI | 1043256845 |
---|---|
Provider Name | Dr. Norbert Rosario |
First Address | Bayamon, PR 00959-8024 |
Second Address | Bayamon, PR 00959-8024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 08/07/2007 |