Provider Demographics
NPI:1598133019
Name:ROSELLON, NAYLAM (FNP)
Entity Type:Individual
Prefix:
First Name:NAYLAM
Middle Name:
Last Name:ROSELLON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 SW 27TH AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33145-1239
Mailing Address - Country:US
Mailing Address - Phone:305-333-0575
Mailing Address - Fax:
Practice Address - Street 1:1400 SW 27TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33145-1239
Practice Address - Country:US
Practice Address - Phone:305-333-0575
Practice Address - Fax:305-503-7500
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9310354363LF0000X
FLARNP9310354363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily