Healthcare Provider Details

I. General information

NPI: 1518895697
Provider Name (Legal Business Name): RHOSEMALINDHA LOUIS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 S LEYDEN ST
BROCKTON MA
02302-3847
US

IV. Provider business mailing address

29 S LEYDEN ST
BROCKTON MA
02302-3847
US

V. Phone/Fax

Practice location:
  • Phone: 904-881-8150
  • Fax:
Mailing address:
  • Phone: 904-881-8150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: