Provider Demographics
NPI:1417966326
Name:BIRD, ROSALINA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ROSALINA
Middle Name:
Last Name:BIRD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 E SAMPLE RD
Mailing Address - Street 2:BLDG 3, BAY 6
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-5144
Mailing Address - Country:US
Mailing Address - Phone:954-943-8737
Mailing Address - Fax:954-943-1358
Practice Address - Street 1:750 E SAMPLE RD
Practice Address - Street 2:BLDG 3, BAY 6
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-5144
Practice Address - Country:US
Practice Address - Phone:954-943-8737
Practice Address - Fax:954-943-1358
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1017232363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner