Provider Demographics
NPI:1790887883
Name:TOUSSAINT, ROSEMARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSEMARIE
Middle Name:
Last Name:TOUSSAINT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROSE
Other - Middle Name:MARIE
Other - Last Name:TOUSSAINT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:121 S ORANGE AVE STE 940
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3234
Mailing Address - Country:US
Mailing Address - Phone:321-332-6935
Mailing Address - Fax:407-658-9688
Practice Address - Street 1:810 N NOWELL ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-7539
Practice Address - Country:US
Practice Address - Phone:407-290-9556
Practice Address - Fax:407-290-9509
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 90856208D00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000620600Medicaid
FL002689900Medicaid
FL002689900Medicaid
FLU6196YMedicare PIN