Healthcare Provider Details
I. General information
NPI: 1952562589
Provider Name (Legal Business Name): ROSE HEALTHCARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2008
Last Update Date: 08/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6638 OLD WINTER GARDEN RD
ORLANDO FL
32835-1231
US
IV. Provider business mailing address
6638 OLD WINTER GARDEN RD
ORLANDO FL
32835-1231
US
V. Phone/Fax
- Phone: 407-298-9211
- Fax: 407-298-9227
- Phone: 407-298-9211
- Fax: 407-298-9227
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NN1001X |
| Taxonomy | Nutrition Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | FL |
VIII. Authorized Official
Name: DR.
BARRY
L
ROSE
Title or Position: PRESIDENT/CO OWNER
Credential: M.S. D.C.
Phone: 407-298-9211