Provider Demographics
NPI:1396964847
Name:CALABRESE, ROSANNE (PHYSICIAN)
Entity type:Individual
Prefix:
First Name:ROSANNE
Middle Name:
Last Name:CALABRESE
Suffix:
Gender:F
Credentials:PHYSICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15881 N WIND CIR
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33326-2114
Mailing Address - Country:US
Mailing Address - Phone:954-249-3494
Mailing Address - Fax:
Practice Address - Street 1:10400 GRIFFIN RD
Practice Address - Street 2:SUITE 204
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-3337
Practice Address - Country:US
Practice Address - Phone:954-680-5500
Practice Address - Fax:954-680-5511
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1705171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist