Provider Demographics
NPI:1487181731
Name:PHYLLIS ROSEN INC
Entity Type:Organization
Organization Name:PHYLLIS ROSEN INC
Other - Org Name:VISITING ANGELSOF SE FLORIDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DILEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-865-9040
Mailing Address - Street 1:5300 W ATLANTIC AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8100
Mailing Address - Country:US
Mailing Address - Phone:561-865-9040
Mailing Address - Fax:888-834-0655
Practice Address - Street 1:5300 W ATLANTIC AVE STE 102
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8100
Practice Address - Country:US
Practice Address - Phone:561-865-9040
Practice Address - Fax:888-834-0655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211369253Z00000X
FL30211262253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30211369OtherNURSE REGISTRY LICENSE
FL30211262OtherNURSE REGISTRY LICENSE