Provider Demographics
NPI:1467902908
Name:ROSALES, ALDO (ARNP)
Entity Type:Individual
Prefix:
First Name:ALDO
Middle Name:
Last Name:ROSALES
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 1:12324 GILMERTON MIST LN
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33579-3939
Mailing Address - Country:US
Mailing Address - Phone:813-471-8142
Mailing Address - Fax:
Practice Address - Street 1:12324 GILMERTON MIST LN
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-3939
Practice Address - Country:US
Practice Address - Phone:813-471-8142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-08
Last Update Date:2016-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9338097363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily