Healthcare Provider Details

I. General information

NPI: 1437053402
Provider Name (Legal Business Name): ROSARIO JARA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 NW 12TH AVE
MIAMI FL
33136-1002
US

IV. Provider business mailing address

131 SW 51ST PL
CORAL GABLES FL
33134-1212
US

V. Phone/Fax

Practice location:
  • Phone: 201-960-9243
  • Fax:
Mailing address:
  • Phone: 201-960-9243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9563726
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: