Provider Demographics
NPI:1396899027
Name:ROSNER, CHERYL (APRN)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:ROSNER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 S FISKE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-4306
Mailing Address - Country:US
Mailing Address - Phone:321-434-8078
Mailing Address - Fax:516-336-5309
Practice Address - Street 1:1425 MALABAR RD NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-2506
Practice Address - Country:US
Practice Address - Phone:321-434-8078
Practice Address - Fax:321-434-8075
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004782363L00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109094500Medicaid
FLNA413OtherFL MEDICARE