MEDICARE: DR. MICHAEL ROSARIO-PRIETO MD

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	2084N0008X	Neuromuscular Medicine (Psychiatry & Neurology) Physician	ME120668	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871738948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ROSARIO-PRIETO MD

Provider Business Mailing Address
First Line	:	PO BOX 1829
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33757-1829
Country	:	US
Telephone Number	:	727-532-0002
Fax Number	:	727-266-4928

Provider Business Practice Location Address
First Line	:	1201 5TH AVE N
Second Line	:	SUITE 202
City	:	ST PETERSBURG
State	:	FL
Zip	:	33705-1410
Country	:	US
Telephone Number	:	727-820-7701
Fax Number	:	727-820-7700

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

Provider Enumeration Date	:	12/03/2008
Last Update Date	:	10/09/2014

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