Provider Demographics
NPI:1700040797
Name:MILANO, ROSALIE J (CRNA)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:J
Last Name:MILANO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ROSALIE
Other - Middle Name:J
Other - Last Name:MCCLAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:68 S. SERVICE RD.
Mailing Address - Street 2:STE 350
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-2358
Mailing Address - Country:US
Mailing Address - Phone:516-945-3107
Mailing Address - Fax:516-945-3131
Practice Address - Street 1:611 ZEAGLER DR
Practice Address - Street 2:
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-3810
Practice Address - Country:US
Practice Address - Phone:386-328-5711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9179048367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG4578OtherBCBS
P00807195OtherRAILROAD MEDICARE
FL000272300Medicaid
FLG4578OtherBCBS
FLAM259ZMedicare PIN