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NPI Code Detail

MEDICARE: DAWN NICHELLE ROSADO MPT

MEDICARE: DAWN NICHELLE ROSADO MPT
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
1225100000XPhysical TherapistPT19721FL

General Provider Information

NPI Number : 1578568952
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAWN NICHELLE ROSADO MPT
Provider Business Mailing Address
First Line : 3599 UNIVERSITY BLVD. SOUTH
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216
Country : US
Telephone Number : 904-854-2090
Fax Number : 904-854-2093
Provider Business Practice Location Address
First Line : 3599 UNIVERSITY BLVD S
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-4252
Country : US
Telephone Number : 904-854-2090
Fax Number : 904-854-2093
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 07/08/2007

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Directions to “ DAWN NICHELLE ROSADO MPT” Practice Location

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