Provider Demographics
NPI:1225327216
Name:ROSSBY, ALBERTA ANITA (CAP)
Entity Type:Individual
Prefix:MS
First Name:ALBERTA
Middle Name:ANITA
Last Name:ROSSBY
Suffix:
Gender:F
Credentials:CAP
Other - Prefix:MS
Other - First Name:ANITA
Other - Middle Name:
Other - Last Name:ROSSBY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CAP
Mailing Address - Street 1:99198 OVERSEAS HWY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-2437
Mailing Address - Country:US
Mailing Address - Phone:305-451-8018
Mailing Address - Fax:305-451-8019
Practice Address - Street 1:99198 OVERSEAS HWY
Practice Address - Street 2:SUITE 5
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-2437
Practice Address - Country:US
Practice Address - Phone:305-451-8018
Practice Address - Fax:305-451-8019
Is Sole Proprietor?:No
Enumeration Date:2011-03-31
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YA0400X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060278700Medicaid