Provider Demographics
NPI:1457127334
Name:ROSARIO, ASHLYN M
Entity Type:Individual
Prefix:
First Name:ASHLYN
Middle Name:M
Last Name:ROSARIO
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 1:500 S FLORIDA AVE STE 415
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-5276
Mailing Address - Country:US
Mailing Address - Phone:863-622-7983
Mailing Address - Fax:863-222-9509
Practice Address - Street 1:500 S FLORIDA AVE STE 415
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-5276
Practice Address - Country:US
Practice Address - Phone:863-622-7983
Practice Address - Fax:863-222-9509
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL23000504349374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide