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General NPI Number Information
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NPI Number | 1902044910
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Entity Type | Organization
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Legal Business Name | DR ROSA CENTER FOR MENTAL HEALTH PA
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Dates
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Enumeration Date | 01/29/2009
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Last Update Date | 03/04/2009
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Provider Practice Location Address
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Address Line | 5451 N UNIVERSITY DR STE 102
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-4641
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Country | US
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Telephone | 954-757-7672
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Fax | 954-757-7670
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Provider Business Mailing Address
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Address Line | 5451 N UNIVERSITY DR STE 102
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-4641
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Country | US
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Telephone | 954-757-7672
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Fax | 954-757-7670
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Authorized Official
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Title or Position | OWNER OPERATOR
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Name | DR. EDWARD PETER ROSA
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Credential | M.M.,M.P.H
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Telephone | 954-757-7672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | ME71617
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License Number State | FL
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