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General NPI Number Information
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NPI Number | 1396686564
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Entity Type | Individual
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Provider Name | MARQUITA ROSALES PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 1737 N CLYDE MORRIS BLVD STE 300
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-5533
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Country | US
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Telephone | 386-262-1627
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Fax |
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Provider Business Mailing Address
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Address Line | 1737 N CLYDE MORRIS BLVD STE 300
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City | DAYTONA BEACH
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State | FL
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Zip | 32117-5533
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Country | US
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Telephone | 386-262-1627
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN9430609
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License Number State | FL
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