Provider Demographics
NPI:1548642572
Name:ANTHONY LEE ROSARIO
Entity type:Organization
Organization Name:ANTHONY LEE ROSARIO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TECHNOLOGYST
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-226-0099
Mailing Address - Street 1:HC 2 BOX 10620
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-9678
Mailing Address - Country:US
Mailing Address - Phone:787-226-0099
Mailing Address - Fax:
Practice Address - Street 1:HC 2 BOX 10620
Practice Address - Street 2:
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-9678
Practice Address - Country:US
Practice Address - Phone:787-226-0099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, CardiologyGroup - Multi-Specialty
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Multi-Specialty
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Multi-Specialty
No2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEGGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR260012753690OtherDRIVER LICENSE