Provider Demographics
NPI:1891172102
Name:ALIFONSO, ROSALIND MARIE
Entity Type:Individual
Prefix:
First Name:ROSALIND
Middle Name:MARIE
Last Name:ALIFONSO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2218 VILLA VERANO WAY
Mailing Address - Street 2:APT 102
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-6367
Mailing Address - Country:US
Mailing Address - Phone:407-361-4525
Mailing Address - Fax:
Practice Address - Street 1:826 PARK LAKE COURT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803
Practice Address - Country:US
Practice Address - Phone:407-717-6049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI 25402355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant