MEDICARE: DR. HEBER J ROSA 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	207Q00000X	Family Medicine Physician	ME0067351	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952306607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEBER J ROSA M.D.

Provider Business Mailing Address
First Line	:	6101 BLUE LAGOON DR STE 200
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3168
Country	:	US
Telephone Number	:	305-500-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 UNIVERSITY BLVD N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32211-7550
Country	:	US
Telephone Number	:	904-900-3667
Fax Number	:	904-900-3278

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

Provider Enumeration Date	:	06/19/2005
Last Update Date	:	02/17/2026

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