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NPI Code Detail

MEDICARE: IRESI ROSADO APRN

MEDICARE: IRESI ROSADO APRN
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
1363LF0000XFamily Nurse Practitioner11014200FL

Other Identifiers

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

General Provider Information

NPI Number : 1467025692
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRESI ROSADO APRN
Provider Business Mailing Address
First Line : 12410 N NEBRASKA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33612-5352
Country : US
Telephone Number : 813-926-3756
Fax Number :
Provider Business Practice Location Address
First Line : 12085 W HILLSBOROUGH AVE
Second Line :
City : TAMPA
State : FL
Zip : 33635-9725
Country : US
Telephone Number : 813-397-5300
Fax Number : 813-738-9010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2021
Last Update Date : 02/22/2024

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