Dermatology Science and Aesthetics PSC

Key facts

NPI: 1922477421
Entity type: Organization (NPI type 2)
Primary specialty: Clinic/Center 261Q00000X
License: 15519 (PR)
Legal business name: DERMATOLOGY SCIENCE AND AESTHETICS PSC
Practice address: Carr 891 KM 13 Pueblo
Plaza del Carmen Suite 308
Corozal, PR 00783-0009
Phone: (787) 365-0315
Fax: (787) 802-2626
NPI assigned: Sep 15, 2015
Organization subpart: No

Authorized official

Name: Dr. Amarylis Rosado, MD
Title: President
Phone: (787) 365-0315

Practitioners 1

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

Amarylis Rosado Rodriguez, MD Dermatology Physician · Corozal, PR · NPI 1780896662

Medicare reassignment PR

Medicare participation

Medicare fee-for-service enrollment: Enrolled in PR

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20160414000244	PR	Part B Supplier - Clinic/Group Practice	4385942028	Receives reassigned benefits from 1 practitioner Practice locations: Corozal, PR

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinic/Center	261Q00000X	15519	PR	Yes

Addresses

Primary practice location

Carr 891 KM 13 Pueblo
Plaza del Carmen Suite 308
Corozal, PR 00783-0009

Mailing address

387 Via Versalles
Villas Reales
Guaynabo, PR 00969-5341
Phone (787) 365-0315

Other identifiers

Identifier	Type	State	Issuer
15519	Other	PR	STATE LISCENSE

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 15, 2015.

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442275200000",
    "number": "1922477421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 VIA VERSALLES",
            "address_2": "VILLAS REALES",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009695341",
            "telephone_number": "787-365-0315",
            "fax_number": "787-802-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CARR 891 KM 13 PUEBLO",
            "address_2": "PLAZA DEL CARMEN SUITE 308",
            "city": "COROZAL",
            "state": "PR",
            "postal_code": "007830009",
            "telephone_number": "787-365-0315",
            "fax_number": "787-802-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY SCIENCE AND AESTHETICS PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A",
        "authorized_official_last_name": "ROSADO",
        "authorized_official_first_name": "AMARYLIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-365-0315",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PR",
            "license": "15519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISCENSE",
            "identifier": "15519",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corozal, PR

All providers in Corozal, PR · Clinic/Center in Puerto Rico

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 15, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.