Healthcare Provider Details

I. General information

NPI: 1235615295
Provider Name (Legal Business Name): ROSE BOSCAINO ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2018
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 BEVILLE RD STE 502
DAYTONA BEACH FL
32114
US

IV. Provider business mailing address

1500 BEVILLE RD STE 502
DAYTONA BEACH FL
32114
US

V. Phone/Fax

Practice location:
  • Phone: 386-231-4690
  • Fax: 386-231-4691
Mailing address:
  • Phone: 386-231-4690
  • Fax: 386-231-4691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberARNP9277737
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9277737
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: