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General NPI Number Information
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NPI Number | 1316546252
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Entity Type | Individual
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Provider Name | ROSEMANY RENE
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Gender | Female
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Dates
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Enumeration Date | 10/21/2020
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 1201 SE INDIAN ST
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City | STUART
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State | FL
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Zip | 34997-5688
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Country | US
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Telephone | 772-403-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 855 SE STARFLOWER AVE
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-4638
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Country | US
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Telephone | 772-646-2942
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11005364
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11005364
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License Number State | FL
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