MEDICARE: CAROLINE LAROSA, LCSW, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW7674	FL

General Provider Information

NPI Number	:	1144501917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAROLINE LAROSA, LCSW, PLLC

Provider Business Mailing Address
First Line	:	1425 S HOWARD AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-3126
Country	:	US
Telephone Number	:	813-368-2947
Fax Number	:

Provider Business Practice Location Address
First Line	:	1425 S HOWARD AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-3126
Country	:	US
Telephone Number	:	813-368-2947
Fax Number	:

Authorized Official
Title or Position	:	LICENSED CLINICAL SOCIAL WORKER
Name	:	MRS. CAROLINE LAROSA
Credential	:	LCSW
Telephone Number	:	813-368-2947

Provider Enumeration Date	:	09/07/2011
Last Update Date	:	09/07/2011

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