Provider Demographics
NPI:1033147780
Name:ROSALES-ZINCONE, JEANNETTE ALICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:JEANNETTE
Middle Name:ALICIA
Last Name:ROSALES-ZINCONE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N ORANGE AVE STE 235
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4659
Mailing Address - Country:US
Mailing Address - Phone:407-303-2906
Mailing Address - Fax:407-303-2553
Practice Address - Street 1:2501 N ORANGE AVE STE 235
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4659
Practice Address - Country:US
Practice Address - Phone:407-303-2906
Practice Address - Fax:407-303-2553
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07757800207R00000X
FLME93550207RH0002X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU55582Medicaid
NJ273081200Medicare ID - Type Unspecified
NJU55582Medicaid