Provider Demographics
NPI:1760255731
Name:ROS, DIANA (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:ROS
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12811 SW 43RD DR APT 215A
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-4164
Mailing Address - Country:US
Mailing Address - Phone:305-322-9644
Mailing Address - Fax:
Practice Address - Street 1:12811 SW 43RD DR APT 215A
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-4164
Practice Address - Country:US
Practice Address - Phone:305-322-9644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11029324363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily