Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 19794 | PR |
NPI | 1043724016 |
---|---|
Provider Name | Victor Josue Rosado Torres |
First Address | Barranquitas, PR 00794-1623 |
Second Address | Barranquitas, PR 00794-1623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2017 |
Last Update Date | 12/03/2021 |