Healthcare Provider Details

I. General information

NPI: 1235078536
Provider Name (Legal Business Name): ROSE NEUROSURGERY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

3692 GRAND AVE # 105
MIAMI FL
33133-4953
US

IV. Provider business mailing address

3692 GRAND AVE # 105
MIAMI FL
33133-4953
US

V. Phone/Fax

Practice location:
  • Phone: 619-372-1002
  • Fax:
Mailing address:
  • Phone: 305-605-7673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEXA LYNNE ROSE
Title or Position: C.E.O.
Credential:
Phone: 619-372-1002