Provider Demographics
NPI:1598903536
Name:ROSADO, RICHARD (MSPT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:ROSADO
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 NE 40TH RD
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5929
Mailing Address - Country:US
Mailing Address - Phone:305-301-5361
Mailing Address - Fax:
Practice Address - Street 1:1041 NE 40TH RD
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5929
Practice Address - Country:US
Practice Address - Phone:305-301-5361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-29
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT22660261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy