Provider Demographics
NPI:1184261869
Name:ROSA, FRANK DAVID (PSYD, BCBA-D)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:DAVID
Last Name:ROSA
Suffix:
Gender:M
Credentials:PSYD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11233 NW 50TH TER
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-3543
Mailing Address - Country:US
Mailing Address - Phone:305-801-8957
Mailing Address - Fax:305-639-3049
Practice Address - Street 1:4001 NW 97TH AVE STE 301I
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-2336
Practice Address - Country:US
Practice Address - Phone:305-801-8957
Practice Address - Fax:305-639-3049
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-02
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-04-1706103K00000X
FLPY8448103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst