Healthcare Provider Details

I. General information

NPI: 1205142171
Provider Name (Legal Business Name): MARISELIS ROSA-SANCHEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2010
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 SUNSET DR STE 303
SOUTH MIAMI FL
33143-4829
US

IV. Provider business mailing address

5955 PONCE DE LEON BLVD
CORAL GABLES FL
33146-2423
US

V. Phone/Fax

Practice location:
  • Phone: 305-661-4318
  • Fax: 833-464-4217
Mailing address:
  • Phone: 305-661-1515
  • Fax: 305-662-3723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberME128266
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: