Provider Demographics
NPI:1407363955
Name:ADOLPHE, ROSEMONDE
Entity Type:Individual
Prefix:
First Name:ROSEMONDE
Middle Name:
Last Name:ADOLPHE
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 1:4014 HIGHWAY 90
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-1918
Mailing Address - Country:US
Mailing Address - Phone:850-723-6570
Mailing Address - Fax:850-994-8443
Practice Address - Street 1:4014 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-1918
Practice Address - Country:US
Practice Address - Phone:850-723-6570
Practice Address - Fax:850-994-8443
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-16-20993106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician