MEDICARE: MRS. LIZBETTE ROSARIO

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	225200000X	Physical Therapy Assistant	PTAT24502	FL

General Provider Information

NPI Number	:	1891124350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LIZBETTE ROSARIO

Provider Business Mailing Address
First Line	:	19189A S DIXIE HWY
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-7714
Country	:	US
Telephone Number	:	786-293-6800
Fax Number	:	786-293-7555

Provider Business Practice Location Address
First Line	:	19189A S DIXIE HWY
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-7714
Country	:	US
Telephone Number	:	786-293-6800
Fax Number	:	786-293-7555

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

Provider Enumeration Date	:	11/05/2013
Last Update Date	:	11/05/2013

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