Healthcare Provider Details

I. General information

NPI: 1043205552
Provider Name (Legal Business Name): ROSEMARY A CIRELLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 06/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1876 NIGHTINGALE LN
TAVARES FL
32778-4359
US

IV. Provider business mailing address

1876 NIGHTINGALE LN
TAVARES FL
32778-4359
US

V. Phone/Fax

Practice location:
  • Phone: 352-742-4447
  • Fax: 352-748-4448
Mailing address:
  • Phone: 352-742-4447
  • Fax: 352-748-4448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME0074542
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME74542
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License NumberME0074542
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: