Provider Demographics
NPI:1497173561
Name:ROSALBA WARNER, PA
Entity Type:Organization
Organization Name:ROSALBA WARNER, PA
Other - Org Name:TWINS SKIN CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MICRO-PIGMENTATION SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSALBA
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-987-8171
Mailing Address - Street 1:15800 PINES BLVD
Mailing Address - Street 2:SUITE 333
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33027-1212
Mailing Address - Country:US
Mailing Address - Phone:305-987-8171
Mailing Address - Fax:
Practice Address - Street 1:15800 PINES BLVD
Practice Address - Street 2:SUITE 333
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33027-1212
Practice Address - Country:US
Practice Address - Phone:305-987-8171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-04
Last Update Date:2017-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL06441527771174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty