Healthcare Provider Details

I. General information

NPI: 1649517244
Provider Name (Legal Business Name): RAFAEL ROSADO LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2013
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 WASHINGTON ST
HOLLYWOOD FL
33021-8216
US

IV. Provider business mailing address

3600 WASHINGTON ST
HOLLYWOOD FL
33021-8216
US

V. Phone/Fax

Practice location:
  • Phone: 954-518-5504
  • Fax: 954-518-5510
Mailing address:
  • Phone: 954-518-5504
  • Fax: 954-518-5510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: