Provider Demographics
NPI:1104068584
Name:ROSADO, JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:ROSADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 636987
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6987
Mailing Address - Country:US
Mailing Address - Phone:352-854-0681
Mailing Address - Fax:352-854-8031
Practice Address - Street 1:3927 ROSEWOOD WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-1034
Practice Address - Country:US
Practice Address - Phone:407-292-2200
Practice Address - Fax:407-292-8210
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17750208D00000X
FLACN336208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDB614WMedicare PIN
FLAC088ZMedicare PIN
FLAC088ZMedicare PIN