Provider Demographics
NPI:1093401689
Name:ROSARIO, HARRY WILLIAM
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:WILLIAM
Last Name:ROSARIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4970 KYNGS HEATH RD APT 211
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-5685
Mailing Address - Country:US
Mailing Address - Phone:787-354-3882
Mailing Address - Fax:
Practice Address - Street 1:5401 S KIRKMAN RD STE 730
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7911
Practice Address - Country:US
Practice Address - Phone:321-332-6984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL163341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical