Provider Demographics
NPI:1477229151
Name:GASPARD, ROSE CARLA DOLDINE (APRN)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:CARLA DOLDINE
Last Name:GASPARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11528 CLUMBET LN
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-3744
Mailing Address - Country:US
Mailing Address - Phone:347-691-4444
Mailing Address - Fax:
Practice Address - Street 1:11528 CLUMBET LN
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33971-3744
Practice Address - Country:US
Practice Address - Phone:347-691-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-21
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11014828363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner