MEDICARE: MRS. SHANNON ROSBOROUGH R.N.

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	2865M2000X	Military General Acute Care Hospital	RN9359274	FL

General Provider Information

NPI Number	:	1538583786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHANNON ROSBOROUGH R.N.

Provider Business Mailing Address
First Line	:	16003 RIDLEY PL
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2050
Country	:	US
Telephone Number	:	910-381-1178
Fax Number	:

Provider Business Practice Location Address
First Line	:	16003 RIDLEY PL
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2050
Country	:	US
Telephone Number	:	910-381-1178
Fax Number	:

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

Provider Enumeration Date	:	02/08/2014
Last Update Date	:	02/08/2014

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Directions to “ MRS. SHANNON ROSBOROUGH R.N.” Practice Location

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