MEDICARE: MS. MARKISHA ROSEMOND APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	11025327	FL

General Provider Information

NPI Number	:	1114629839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARKISHA ROSEMOND APRN

Provider Business Mailing Address
First Line	:	5233 WHITE CHICORY DR
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-3546
Country	:	US
Telephone Number	:	727-331-5490
Fax Number	:

Provider Business Practice Location Address
First Line	:	5233 WHITE CHICORY DR
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-3546
Country	:	US
Telephone Number	:	727-331-5490
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2023
Last Update Date	:	03/17/2023

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