Provider Demographics
NPI:1952104739
Name:DAROSA, NATHAN MANUEL
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:MANUEL
Last Name:DAROSA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-4823
Mailing Address - Country:US
Mailing Address - Phone:401-359-0674
Mailing Address - Fax:
Practice Address - Street 1:7900 ARLINGTON CIR # 49
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-3218
Practice Address - Country:US
Practice Address - Phone:239-307-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA33874225200000X
RIPTA01340225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant