Healthcare Provider Details
I. General information
NPI: 1932638947
Provider Name (Legal Business Name): ROSALIA CUOZZO-TAYLOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/05/2017
Last Update Date: 07/19/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7243 DELLA DR STE K
ORLANDO FL
32819-5106
US
IV. Provider business mailing address
7243 DELLA DR STE K
ORLANDO FL
32819-5106
US
V. Phone/Fax
- Phone: 407-381-7366
- Fax: 321-203-4630
- Phone: 407-381-7366
- Fax: 321-203-4630
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 125070343 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | ME144669 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: