Provider Demographics
NPI:1558835116
Name:KARAGIANNIS, ROSSANA MICHELLE (CNM)
Entity Type:Individual
Prefix:
First Name:ROSSANA
Middle Name:MICHELLE
Last Name:KARAGIANNIS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:ROSIE
Other - Middle Name:MICHELLE
Other - Last Name:KARAGIANNIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNM
Mailing Address - Street 1:13956 MORNING FROST DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-7477
Mailing Address - Country:US
Mailing Address - Phone:386-366-0628
Mailing Address - Fax:
Practice Address - Street 1:630 MAIN ST
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-6413
Practice Address - Country:US
Practice Address - Phone:407-442-1017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001355367A00000X
FLCNM05354367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN11001355OtherSTATE LICENSE