MEDICARE: ROCCOROSE WELLNESS CORP

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1922890680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCCOROSE WELLNESS CORP

Provider Business Mailing Address
First Line	:	12832 SW 222ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33170-4425
Country	:	US
Telephone Number	:	305-345-7347
Fax Number	:

Provider Business Practice Location Address
First Line	:	12832 SW 222ND ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33170-4425
Country	:	US
Telephone Number	:	305-345-7347
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	ROSEMARY ANGELICA CORNETT
Credential	:	LCSW
Telephone Number	:	305-345-7347

Provider Enumeration Date	:	05/20/2025
Last Update Date	:	05/20/2025

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Directions to “ROCCOROSE WELLNESS CORP ” Practice Location

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