Organization Active NPI

Cristobal R. Rosario M.D., P.a.

  • Internal Medicine Physician
  • Palm Harbor, FL
National Provider Identifier
1124252838
Registry record updated May 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0068810 Issued in FL
Legal business name
CRISTOBAL R. ROSARIO M.D., P.A.
Practice address
3890 Tampa Road
Suite 307
Palm Harbor, FL 34684-3677
Phone
(727) 786-6155
Fax
(727) 781-9899
NPI assigned
May 8, 2009
Organization subpart
Yes
Parent organization
CRISTOBAL R. ROSARIO M.D., P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 8, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cristobal R Rosario, M.D.NPI 1104808153
Title
M.D.
Phone
(727) 786-6155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X ME0068810 FL Primary

Addresses

Primary practice location

3890 Tampa Road
Suite 307
Palm Harbor, FL 34684-3677

Mailing address

3890 Tampa Road
Suite 307
Palm Harbor, FL 34684-3677
Phone (727) 786-6155

Other identifiers 2

IdentifierTypeStateIssuer
264028700MedicaidFL
378616100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130207000036 FL Part B Supplier - Clinic/Group Practice 7315191996 Receives reassigned benefits from 1 practitioner
Practice locations: New Port Richey, FL; Palm Harbor, FL

National Provider Directory

National Provider Directory
Part of
Cristobal R Rosario MD PA

Locations

4740 Rowan Rd
New Port Richey, FL 34653
Phone (727) 392-8682

3830 Tampa Rd
Ste 500
Palm Harbor, FL 34684
Phone (727) 786-6155

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241740800000",
    "number": "1124252838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 TAMPA ROAD",
            "address_2": "SUITE 307",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843677",
            "telephone_number": "727-786-6155",
            "fax_number": "727-781-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 TAMPA ROAD",
            "address_2": "SUITE 307",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843677",
            "telephone_number": "727-786-6155",
            "fax_number": "727-781-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISTOBAL R. ROSARIO M.D., P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CRISTOBAL R. ROSARIO M.D., P.A.",
        "enumeration_date": "2009-05-08",
        "last_updated": "2009-05-08",
        "status": "A",
        "authorized_official_last_name": "ROSARIO",
        "authorized_official_first_name": "CRISTOBAL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "727-786-6155",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0068810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264028700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378616100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.