Provider Demographics
NPI:1205643152
Name:EXANTUS, ROSE-ASLINE
Entity type:Individual
Prefix:
First Name:ROSE-ASLINE
Middle Name:
Last Name:EXANTUS
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 1:9684 MOSS ROSE WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5806
Mailing Address - Country:US
Mailing Address - Phone:407-496-9448
Mailing Address - Fax:
Practice Address - Street 1:9684 MOSS ROSE WAY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-5806
Practice Address - Country:US
Practice Address - Phone:407-496-9448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter