MEDICARE: ROSE LUNIDE CALIXTE 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
1	363LF0000X	Family Nurse Practitioner	9346795	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	9346795	FL

General Provider Information

NPI Number	:	1750851861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSE LUNIDE CALIXTE APRN

Provider Business Mailing Address
First Line	:	4289 URQUHART ST # SR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4364
Country	:	US
Telephone Number	:	561-900-5883
Fax Number	:

Provider Business Practice Location Address
First Line	:	4289 URQUHART ST # SR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461-4364
Country	:	US
Telephone Number	:	561-900-5883
Fax Number	:

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

Provider Enumeration Date	:	12/01/2018
Last Update Date	:	12/28/2020

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