=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538040977
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROSE GOLD CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2025
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5130 LINTON BLVD STE H1
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33484-6597
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-909-1044
-----------------------------------------------------
Fax | 954-909-1044
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5130 LINTON BLVD STE H1
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33484-6597
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-909-1044
-----------------------------------------------------
Fax | 954-909-1044
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MANAGING
-----------------------------------------------------
Name | MS. SUDLAIRE THERESA CHARLOTIN
-----------------------------------------------------
Credential | MSN, RN, FNP-BC
-----------------------------------------------------
Telephone | 954-909-1044
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------