MEDICARE: DR. ROBB LA ROSA

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	152W00000X	Optometrist	OPC5200	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	:	1952759102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBB LA ROSA

Provider Business Mailing Address
First Line	:	6737 MONARCH PARK DR
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-8107
Country	:	US
Telephone Number	:	813-362-0538
Fax Number	:

Provider Business Practice Location Address
First Line	:	6737 MONARCH PARK DR
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-8107
Country	:	US
Telephone Number	:	813-362-0538
Fax Number	:

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

Provider Enumeration Date	:	05/27/2016
Last Update Date	:	05/27/2016

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Directions to “ DR. ROBB LA ROSA ” Practice Location

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