Provider Demographics
NPI:1225236706
Name:ROSARIO, LUZ DELIA (MD)
Entity Type:Individual
Prefix:DR
First Name:LUZ
Middle Name:DELIA
Last Name:ROSARIO
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 1:2202 SE 17TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-2623
Mailing Address - Country:US
Mailing Address - Phone:352-204-9866
Mailing Address - Fax:352-204-9661
Practice Address - Street 1:2202 SE 17TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-2623
Practice Address - Country:US
Practice Address - Phone:352-204-9866
Practice Address - Fax:352-204-9661
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN-203208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLACN203OtherMEDICAL LICENSE