MEDICARE: ROSYLN PATRICK

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	163WC0400X	Case Management Registered Nurse	9359634	FL

General Provider Information

NPI Number	:	1861360786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSYLN PATRICK

Provider Business Mailing Address
First Line	:	400 S DAVIS ST
Second Line	:
City	:	LABELLE
State	:	FL
Zip	:	33935-4827
Country	:	US
Telephone Number	:	813-767-1813
Fax Number	:

Provider Business Practice Location Address
First Line	:	5555 W BLUE HERON BLVD
Second Line	:
City	:	RIVIERA BEACH
State	:	FL
Zip	:	33418-7815
Country	:	US
Telephone Number	:	561-863-2100
Fax Number	:

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

Provider Enumeration Date	:	10/24/2025
Last Update Date	:	10/24/2025

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Directions to “ ROSYLN PATRICK ” Practice Location

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