Provider Demographics
NPI:1811923899
Name:ROSA CUNHA, ISABELLA (MD)
Entity type:Individual
Prefix:DR
First Name:ISABELLA
Middle Name:
Last Name:ROSA CUNHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 NW 12TH AVE
Mailing Address - Street 2:JMT-EAST 1007
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1028
Mailing Address - Country:US
Mailing Address - Phone:305-243-4664
Mailing Address - Fax:305-243-8470
Practice Address - Street 1:1475 NW 12TH AVE
Practice Address - Street 2:BOX 025775 M851
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1002
Practice Address - Country:US
Practice Address - Phone:305-243-7618
Practice Address - Fax:305-243-8470
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN3067207RI0200X
FLME0096278207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2757753-00Medicaid
FLU7793YOtherMEDICARE