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General NPI Number Information
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NPI Number | 1144769860
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Entity Type | Organization
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Legal Business Name | ROSE Q. BASILE, LLC
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Dates
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Enumeration Date | 02/14/2017
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Last Update Date | 02/14/2017
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Provider Practice Location Address
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Address Line | 199 CYPRESS TRCE
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-4960
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Country | US
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Telephone | 561-386-3986
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Fax |
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Provider Business Mailing Address
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Address Line | 199 CYPRESS TRCE
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City | ROYAL PALM BEACH
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State | FL
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Zip | 33411-4960
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Country | US
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Telephone | 561-386-3986
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Fax |
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Authorized Official
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Title or Position | SPEECH-LANGUAGE PATHOLOGIST
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Name | MRS. ROCIO Q BASILE
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Credential | M.S., SLP
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Telephone | 561-386-3986
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA115070
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License Number State | FL
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