Healthcare Provider Details

I. General information

NPI: 1699372003
Provider Name (Legal Business Name): ROSIE MICHEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2020
Last Update Date: 03/15/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12955 BISCAYNE BLVD
NORTH MIAMI FL
33181-2037
US

IV. Provider business mailing address

12955 BISCAYNE BLVD STE 320
NORTH MIAMI FL
33181-2022
US

V. Phone/Fax

Practice location:
  • Phone: 305-895-3231
  • Fax: 305-895-3271
Mailing address:
  • Phone: 305-895-3231
  • Fax: 305-895-3271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11009482
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: