MEDICARE: ROSEMARY T. HALEY ARNP

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	363LG0600X	Gerontology Nurse Practitioner	1697822	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	500017976	OTHER	FL	MEDICARE RR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396731881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSEMARY T. HALEY ARNP

Provider Business Mailing Address
First Line	:	425 NURSING HOME DR
Second Line	:
City	:	ARCADIA
State	:	FL
Zip	:	34266-3839
Country	:	US
Telephone Number	:	863-491-8889
Fax Number	:	863-494-0759

Provider Business Practice Location Address
First Line	:	1540 S TAMIAMI TRL STE 401
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34239-2921
Country	:	US
Telephone Number	:	941-917-0060
Fax Number	:	941-552-0316

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	04/25/2017

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