Lissette Ann Marie Davis Rosario

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

23305 Issued in PR

Practice address

70 Calle Santa Cruz
Bayamon, PR 00961-7052

Phone

(787) 387-9520

NPI assigned

Feb 8, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1942954078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "URB. PUERTO NUEVO 1371 CALLE 12 NW",
            "address_2": "APT 4",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00920",
            "telephone_number": "787-387-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 CALLE SANTA CRUZ",
            "city": "BAYAMON",
            "state": "PR",
            "postal_code": "009617052",
            "telephone_number": "787-387-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS ROSARIO",
        "first_name": "LISSETTE",
        "middle_name": "ANN MARIE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-08",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "16085I",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "23305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edny M Davila, PT
• Jose R Davila, PHD
• Lisette Davila
• Melissa Davila, NL
• Ruth Davila, MT
• William R Davis, DC
• Dca Emergency Service PSC
• Gabriela R De Boer, M.D.
• De Jesus & Matos Medical Imaging Professionals, P.S.C.
• De Jesus & Matos Medical Imaging Professionals, PSC

• General Practice Physician in Bayamon, PR
• Providers in Bayamon, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.