MEDICARE: DR. JAVIER ANTONIO ROSARIO 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	208D00000X	General Practice Physician	12579	PR
2	208D00000X	General Practice Physician	ACN987	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ACN987	OTHER	FL	MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568461945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAVIER ANTONIO ROSARIO M.D.

Provider Business Mailing Address
First Line	:	6675 WESTWOOD BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32821-8061
Country	:	US
Telephone Number	:	407-845-0330
Fax Number	:	888-972-1752

Provider Business Practice Location Address
First Line	:	2285 S SEMORAN BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-2703
Country	:	US
Telephone Number	:	407-955-4464
Fax Number	:	321-282-6768

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	06/02/2023

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