Healthcare Provider Details

I. General information

NPI: 1104488337
Provider Name (Legal Business Name): ROSE PHILIUS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 S CONGRESS AVE
WEST PALM BEACH FL
33406-7608
US

IV. Provider business mailing address

2330 S CONGRESS AVE
WEST PALM BEACH FL
33406-7608
US

V. Phone/Fax

Practice location:
  • Phone: 561-432-5849
  • Fax: 561-432-9732
Mailing address:
  • Phone: 561-432-5849
  • Fax: 561-432-9732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11003450
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN11003450
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: