Healthcare Provider Details

I. General information

NPI: 1790604379
Provider Name (Legal Business Name): DR. ALFREDO ALAIN ROSSELLO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

14591 SW 120TH ST
MIAMI FL
33186-8638
US

IV. Provider business mailing address

1501 SW 37TH AVE APT 1205
MIAMI FL
33145-1156
US

V. Phone/Fax

Practice location:
  • Phone: 305-762-1400
  • Fax:
Mailing address:
  • Phone: 786-801-4262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT44818
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: