Healthcare Provider Details

I. General information

NPI: 1205432341
Provider Name (Legal Business Name): ROSELANDE LOUIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5205 GREENWOOD AVE STE 105
WEST PALM BEACH FL
33407-2400
US

IV. Provider business mailing address

3301 N UNIVERSITY DR STE 100
CORAL SPRINGS FL
33065-4149
US

V. Phone/Fax

Practice location:
  • Phone: 561-244-9499
  • Fax: 561-345-3800
Mailing address:
  • Phone: 954-231-4625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMT3406
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT5178
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: