Provider Demographics
NPI:1922993450
Name:ROSARIO, LUIS A (EDD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:A
Last Name:ROSARIO
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:429 CALLE LOS PINOS APT 901
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917-3456
Mailing Address - Country:US
Mailing Address - Phone:787-640-5686
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:429 CALLE LOS PINOS APT 901
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00917-3456
Practice Address - Country:US
Practice Address - Phone:787-640-5686
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-12
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR00373174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty