Provider Demographics
NPI:1013564889
Name:AQUINO ROSADO, LETICIA (APRN)
Entity type:Individual
Prefix:MRS
First Name:LETICIA
Middle Name:
Last Name:AQUINO ROSADO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4903 BANNING ST
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33971-6565
Mailing Address - Country:US
Mailing Address - Phone:239-285-8220
Mailing Address - Fax:
Practice Address - Street 1:3660 CENTRAL AVE STE 9
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-8258
Practice Address - Country:US
Practice Address - Phone:239-245-7171
Practice Address - Fax:239-245-7115
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002931363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily