Provider Demographics
NPI:1396044152
Name:ROSARIO, SYLVIA I (AP, DOM)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:I
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:AP, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 PARK LAKE PL
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-6363
Mailing Address - Country:US
Mailing Address - Phone:407-591-6486
Mailing Address - Fax:407-641-8073
Practice Address - Street 1:227 N JOHN YOUNG PKWY STE A
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4983
Practice Address - Country:US
Practice Address - Phone:407-591-6486
Practice Address - Fax:407-641-8073
Is Sole Proprietor?:No
Enumeration Date:2011-03-19
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA49874225700000X
FLNO374U00000X
FLAP 2958171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL102850500Medicaid