Healthcare Provider Details

I. General information

NPI: 1144296971
Provider Name (Legal Business Name): ROSE-VALENTINE A GONCALVES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. ROSE-VALENTINE ANTOINE

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 08/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 475 US NAVAL HOSPITAL YOKOSUKA, BOX 1, CODE 034
FPO AP
96350-9998
US

IV. Provider business mailing address

US NAVAL HOSPITAL YOKOSUKA, JAPAN PSC 475 BOX 1, CODE 034
FPO AP
96350-1600
US

V. Phone/Fax

Practice location:
  • Phone: 01181468165564
  • Fax: 01181468168650
Mailing address:
  • Phone: 01181468165564
  • Fax: 01181468168650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101241668
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA92961
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: