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General NPI Number Information
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NPI Number | 1861091332
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Entity Type | Organization
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Legal Business Name | ROSE MEDICAL GROUP LLC
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Dates
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Enumeration Date | 10/25/2020
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Last Update Date | 10/25/2020
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Provider Practice Location Address
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Address Line | 8903 REGENTS PARK DR STE 120
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City | TAMPA
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State | FL
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Zip | 33647-3083
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Country | US
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Telephone | 813-482-8241
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Fax | 813-364-6117
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Provider Business Mailing Address
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Address Line | 8903 REGENTS PARK DR STE 120
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City | TAMPA
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State | FL
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Zip | 33647-3083
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Country | US
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Telephone | 813-482-8241
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Fax |
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Authorized Official
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Title or Position | HEALTHCARE PROVIDER
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Name | UNYIME JOSEPH USORO
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Credential | APRN-C
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Telephone | 813-482-8241
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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 |
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License Number State |
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