Provider Demographics
NPI:1407318629
Name:ANDINO, ROSA EMILY (BA)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:EMILY
Last Name:ANDINO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 ALABAMA WOODS LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-8891
Mailing Address - Country:US
Mailing Address - Phone:939-275-3828
Mailing Address - Fax:
Practice Address - Street 1:7550 FUTURES DR STE 105
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-9096
Practice Address - Country:US
Practice Address - Phone:470-730-7983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator