Healthcare Provider Details

I. General information

NPI: 1083985717
Provider Name (Legal Business Name): ELIZABETH N ROSAINZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH N VAN HORN ARNP

II. Dates (important events)

Enumeration Date: 01/26/2012
Last Update Date: 02/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 SE SALERNO ROAD
STUART FL
34997
US

IV. Provider business mailing address

900 SE SALERNO ROAD
STUART FL
34997
US

V. Phone/Fax

Practice location:
  • Phone: 772-223-7803
  • Fax: 772-463-0091
Mailing address:
  • Phone: 772-223-7803
  • Fax: 772-463-0091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9331173
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: