Healthcare Provider Details

I. General information

NPI: 1306577358
Provider Name (Legal Business Name): ROSIE BUZATU MMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2022
Last Update Date: 06/21/2022
Certification Date: 06/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 SW SPOONBILL DR
PALM CITY FL
34990-4641
US

IV. Provider business mailing address

2123 SW SPOONBILL DR
PALM CITY FL
34990-4641
US

V. Phone/Fax

Practice location:
  • Phone: 561-414-3173
  • Fax:
Mailing address:
  • Phone: 561-414-3173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number20395
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: