Provider Demographics
NPI:1013564889
Name:AQUINO ROSADO, LETICIA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:LETICIA
Middle Name:
Last Name:AQUINO ROSADO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4410 OUTER DR. UNIT B
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112
Mailing Address - Country:US
Mailing Address - Phone:239-821-7619
Mailing Address - Fax:
Practice Address - Street 1:5262 GOLDEN GATE PKWY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116
Practice Address - Country:US
Practice Address - Phone:239-455-5105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002931363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily