Provider Demographics
NPI:1417471152
Name:LA ROSA, EDUARDO MANUEL (ARNP)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:MANUEL
Last Name:LA ROSA
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2572 TAMISOLA ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34237-8132
Mailing Address - Country:US
Mailing Address - Phone:941-504-5585
Mailing Address - Fax:
Practice Address - Street 1:1565 STATE ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-5808
Practice Address - Country:US
Practice Address - Phone:941-927-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9302277363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health