Most Relevant Information
Provider Data
| NPI Number: | 1003428319 |
| Provider Name: | JEANNIE LEE ROSARIO OTERO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/18/2020 |
| Last Updated: | 08/18/2020 |
Provider Practice Location
395 ZONA INDUSTRIAL REPARADA 2 CALLE DR. LUIS F. SALA P
PONCE
PR
007162348
Practice Location Phone/Fax
| Phone: | 7878402575 |
| Fax: |
Provider Mailing Location
PO BOX 7004
PONCE
PR
007327004
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |