Provider Demographics
NPI:1346370814
Name:VASILESCU, RODICA
Entity Type:Individual
Prefix:
First Name:RODICA
Middle Name:
Last Name:VASILESCU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 MARQUESAS CIR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-3310
Mailing Address - Country:US
Mailing Address - Phone:941-925-9532
Mailing Address - Fax:941-556-9900
Practice Address - Street 1:5602 MARQUESAS CIR
Practice Address - Street 2:SUITE 105
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-3310
Practice Address - Country:US
Practice Address - Phone:941-925-9532
Practice Address - Fax:941-556-9900
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9368768363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9368768OtherMEDICAL LICENSE