Provider Demographics
NPI:1083908743
Name:ZWIR-VITIELLO, ROSALIE RITA (AUD)
Entity Type:Individual
Prefix:DR
First Name:ROSALIE
Middle Name:RITA
Last Name:ZWIR-VITIELLO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 67
Mailing Address - Street 2:
Mailing Address - City:SCOTTSMOOR
Mailing Address - State:FL
Mailing Address - Zip Code:32775-0067
Mailing Address - Country:US
Mailing Address - Phone:321-383-0324
Mailing Address - Fax:
Practice Address - Street 1:3757 OLD DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIMS
Practice Address - State:FL
Practice Address - Zip Code:32754-5546
Practice Address - Country:US
Practice Address - Phone:321-269-4530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-30
Last Update Date:2011-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1196231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist