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General NPI Number Information
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NPI Number | 1336879402
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Entity Type | Individual
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Provider Name | OLIVIA ROSATO DMD
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Gender | Female
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Dates
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Enumeration Date | 06/13/2022
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Last Update Date | 06/13/2022
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Provider Practice Location Address
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Address Line | 2202 DUCK SLOUGH BLVD STE 104
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City | TRINITY
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State | FL
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Zip | 34655-5071
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Country | US
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Telephone | 727-375-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 3639 HALBERT DR
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City | PALM HARBOR
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State | FL
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Zip | 34685-3693
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Country | US
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Telephone | 727-458-0702
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN27008
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License Number State | FL
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