MEDICARE: MRS. ALICIA GILL ROSSITER ARNP, BC

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	363LF0000X	Family Nurse Practitioner	2620002	FL

General Provider Information

NPI Number	:	1417084880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALICIA GILL ROSSITER ARNP, BC

Provider Business Mailing Address
First Line	:	42 AEGEAN AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-3310
Country	:	US
Telephone Number	:	813-251-3973
Fax Number	:

Provider Business Practice Location Address
First Line	:	1202 E PALM AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33605-3512
Country	:	US
Telephone Number	:	813-273-7020
Fax Number	:

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

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	07/08/2007

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