Provider Demographics
NPI:1205669645
Name:ILARDO, ROSANNE (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:ROSANNE
Middle Name:
Last Name:ILARDO
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 COLLINGTON CT
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-8922
Mailing Address - Country:US
Mailing Address - Phone:862-216-4004
Mailing Address - Fax:
Practice Address - Street 1:18 COLLINGTON CT
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-8922
Practice Address - Country:US
Practice Address - Phone:862-216-4004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9247939163W00000X
FLL313071163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse