MEDICARE: MRS. ROSALINA BIRD ARNP

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	363L00000X	Nurse Practitioner	1017232	FL

General Provider Information

NPI Number	:	1417966326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROSALINA BIRD ARNP

Provider Business Mailing Address
First Line	:	750 E SAMPLE RD
Second Line	:	BLDG 3, BAY 6
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-5144
Country	:	US
Telephone Number	:	954-943-8737
Fax Number	:	954-943-1358

Provider Business Practice Location Address
First Line	:	750 E SAMPLE RD
Second Line	:	BLDG 3, BAY 6
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-5144
Country	:	US
Telephone Number	:	954-943-8737
Fax Number	:	954-943-1358

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

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	07/08/2007

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