Provider Demographics
NPI:1205387495
Name:METAYER, ROSELYN
Entity type:Individual
Prefix:
First Name:ROSELYN
Middle Name:
Last Name:METAYER
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 1:12798 FOREST HILL BLVD STE 205A
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4751
Mailing Address - Country:US
Mailing Address - Phone:954-326-8551
Mailing Address - Fax:
Practice Address - Street 1:1509 NW 21ST ST
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-2820
Practice Address - Country:US
Practice Address - Phone:305-609-7403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-22
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities