Provider Demographics
NPI:1770578890
Name:DE ROSADO, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:DE ROSADO
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 1:1301 N DAVIS ST
Mailing Address - Street 2:#502
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32209-6639
Mailing Address - Country:US
Mailing Address - Phone:904-353-6674
Mailing Address - Fax:904-353-6674
Practice Address - Street 1:1301 N DAVIS ST
Practice Address - Street 2:#502
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32209-6639
Practice Address - Country:US
Practice Address - Phone:904-353-6674
Practice Address - Fax:904-353-6674
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist