Healthcare Provider Details

I. General information

NPI: 1386767655
Provider Name (Legal Business Name): AMROSE CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 W CREST AVE
TAMPA FL
33614-6805
US

IV. Provider business mailing address

2520 W CREST AVE
TAMPA FL
33614-6805
US

V. Phone/Fax

Practice location:
  • Phone: 813-872-8296
  • Fax: 813-872-0133
Mailing address:
  • Phone: 813-872-8296
  • Fax: 813-872-0133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberAL9083
License Number StateFL

VIII. Authorized Official

Name: MR. REUEL F DE LA ROSA
Title or Position: PRESIDENT
Credential:
Phone: 813-872-8296