Healthcare Provider Details

I. General information

NPI: 1477008050
Provider Name (Legal Business Name): JENNIFER EVE ROSENBERG-OCADIZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 PLATINUM PT
LAKE MARY FL
32746-5702
US

IV. Provider business mailing address

PO BOX 9671
DAYTONA BEACH FL
32120-9671
US

V. Phone/Fax

Practice location:
  • Phone: 407-878-0910
  • Fax: 407-878-0911
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9265362
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: