Individual
REYNALDO S. DELA ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
01060859
IN
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
202653
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200529540
—
IN
05
—
207482605
—
MO
05
—
2869472
—
OH
01
—
302I816792
MEDICARE PTAN
MS
Enumeration date
08/30/2006
Last updated
06/18/2025
Update your record
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