Provider Demographics
NPI:1639605058
Name:ROSIERE, SCOTT (PAY D)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:ROSIERE
Suffix:
Gender:M
Credentials:PAY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 W MOUNT VERNON DR
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33325-3607
Mailing Address - Country:US
Mailing Address - Phone:954-873-8928
Mailing Address - Fax:
Practice Address - Street 1:480 WEST MOUNT VERNON DRIVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33325
Practice Address - Country:US
Practice Address - Phone:954-873-8928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7076103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical