MEDICARE: MARIA DE ROSADO

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	373H00000X	Day Training/Habilitation Specialist

General Provider Information

NPI Number	:	1770578890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA DE ROSADO

Provider Business Mailing Address
First Line	:	1301 N DAVIS ST
Second Line	:	#502
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-6639
Country	:	US
Telephone Number	:	904-353-6674
Fax Number	:	904-353-6674

Provider Business Practice Location Address
First Line	:	1301 N DAVIS ST
Second Line	:	#502
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-6639
Country	:	US
Telephone Number	:	904-353-6674
Fax Number	:	904-353-6674

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	07/09/2007

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Directions to “ MARIA DE ROSADO ” Practice Location

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