Healthcare Provider Details

I. General information

NPI: 1912202318
Provider Name (Legal Business Name): ROSEMARY DAWN ROSADO MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2011
Last Update Date: 01/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2180 MARAVILLA LN
FORT MYERS FL
33901-7221
US

IV. Provider business mailing address

11206 CYPRESS TREE CIR
FORT MYERS FL
33913-7821
US

V. Phone/Fax

Practice location:
  • Phone: 239-332-8009
  • Fax: 239-332-4977
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: