Provider Demographics
NPI:1205008646
Name:TROWBRIDGE, ROSE STAVINOHA (MD)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:STAVINOHA
Last Name:TROWBRIDGE
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:PO BOX 76479
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33734-6479
Mailing Address - Country:US
Mailing Address - Phone:727-329-5400
Mailing Address - Fax:727-329-5402
Practice Address - Street 1:601 5TH ST S
Practice Address - Street 2:SUITE 701
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4804
Practice Address - Country:US
Practice Address - Phone:727-329-5400
Practice Address - Fax:727-329-5402
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6682207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008973400Medicaid
TX095065103Medicaid
TX219159501Medicaid