Provider Demographics
NPI:1740171404
Name:ROSENDO, OSCAR
Entity type:Individual
Prefix:MR
First Name:OSCAR
Middle Name:
Last Name:ROSENDO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11405 NW 74TH TER
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-1573
Mailing Address - Country:US
Mailing Address - Phone:786-282-6176
Mailing Address - Fax:786-282-6176
Practice Address - Street 1:11405 NW 74TH TER
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-1573
Practice Address - Country:US
Practice Address - Phone:786-282-6176
Practice Address - Fax:786-282-6176
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21-483246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant