Healthcare Provider Details

I. General information

NPI: 1952765455
Provider Name (Legal Business Name): REZPAR ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2016
Last Update Date: 04/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2375 NE 25TH AVE SUITE 106
OCALA FL
34470-3973
US

IV. Provider business mailing address

2375 NE 25TH AVE SUITE 106
OCALA FL
34470-3973
US

V. Phone/Fax

Practice location:
  • Phone: 352-350-1619
  • Fax:
Mailing address:
  • Phone: 352-350-1619
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK ROSSELI
Title or Position: PRESIDENT/CEO
Credential:
Phone: 954-415-4944