Provider Demographics
NPI:1558341354
Name:DALY, ROSEMARY (DO)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:DALY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 817737
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33081-1737
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1951 SW 172ND AVE
Practice Address - Street 2:#314
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-5593
Practice Address - Country:US
Practice Address - Phone:954-447-5206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6088207LP2900X, 208VP0014X
NY185865-01208VP0014X
GA87411208VP0014X
WAOP60925820208VP0014X
KY04893208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL80632OtherBCBS
FL370329100Medicaid
F30890Medicare UPIN
FL370329100Medicaid
FL80632ZMedicare PIN
FL80632YMedicare PIN
FL80632OtherBCBS