Healthcare Provider Details

I. General information

NPI: 1639889330
Provider Name (Legal Business Name): VALENTINA ROSSI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 12/05/2022
Certification Date: 11/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5768 S SEMORAN BLVD
ORLANDO FL
32822-4818
US

IV. Provider business mailing address

3004 PINEWAY AVE
LAKELAND FL
33803-4320
US

V. Phone/Fax

Practice location:
  • Phone: 407-896-2323
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: