Provider Demographics
NPI:1346786142
Name:DELVA, ROSE L (MD/MSN/FNP/APRN)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:L
Last Name:DELVA
Suffix:
Gender:F
Credentials:MD/MSN/FNP/APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6080 SW 180TH TER
Mailing Address - Street 2:
Mailing Address - City:SOUTHWEST RANCHES
Mailing Address - State:FL
Mailing Address - Zip Code:33331-1604
Mailing Address - Country:US
Mailing Address - Phone:954-865-7548
Mailing Address - Fax:305-653-0590
Practice Address - Street 1:6080 SW 180TH TER
Practice Address - Street 2:
Practice Address - City:SOUTHWEST RANCHES
Practice Address - State:FL
Practice Address - Zip Code:33331-1604
Practice Address - Country:US
Practice Address - Phone:954-865-7548
Practice Address - Fax:305-653-0590
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1699162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily