MEDICARE: DR. VANESSA MARIE ROSA M.D

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	207R00000X	Internal Medicine Physician	ME135130	FL
2	390200000X	Student in an Organized Health Care Education/Training Program	TRN# 21415	FL

General Provider Information

NPI Number	:	1164803268
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VANESSA MARIE ROSA M.D

Provider Business Mailing Address
First Line	:	17417 BRIDGE HILL CT
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3467
Country	:	US
Telephone Number	:	813-972-7900
Fax Number	:	813-355-5035

Provider Business Practice Location Address
First Line	:	17417 BRIDGE HILL CT
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3467
Country	:	US
Telephone Number	:	813-972-7900
Fax Number	:	813-355-5035

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

Provider Enumeration Date	:	06/15/2015
Last Update Date	:	04/17/2026

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