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General NPI Number Information
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NPI Number | 1053358168
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Entity Type | Individual
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Provider Name | ARIEL JESUS DE LA ROSA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 01/28/2020
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Provider Practice Location Address
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Address Line | 2387 W 68TH ST SUITE 503
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City | HIALEAH
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State | FL
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Zip | 33016-6889
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Country | US
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Telephone | 305-232-0170
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Fax |
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Provider Business Mailing Address
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Address Line | 625 TAMIAMI TRL N STE 201
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City | NAPLES
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State | FL
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Zip | 34102-8143
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Country | US
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Telephone | 239-261-2000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 95915
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License Number State | FL
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