MEDICARE: AMROSE CARE, INC.

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	310400000X	Assisted Living Facility	AL9083	FL

General Provider Information

NPI Number	:	1386767655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMROSE CARE, INC.

Provider Business Mailing Address
First Line	:	2520 W CREST AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-6805
Country	:	US
Telephone Number	:	813-872-8296
Fax Number	:	813-872-0133

Provider Business Practice Location Address
First Line	:	2520 W CREST AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-6805
Country	:	US
Telephone Number	:	813-872-8296
Fax Number	:	813-872-0133

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. REUEL F DE LA ROSA
Credential	:
Telephone Number	:	813-872-8296

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	08/22/2020

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