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NPI Code Detail

MEDICARE: SARA DE LA ROSA M.D.

MEDICARE: SARA DE LA 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
1207W00000XOphthalmology Physician0101266362VA
2207W00000XOphthalmology Physician036154010IL

General Provider Information

NPI Number : 1992190821
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARA DE LA ROSA M.D.
Provider Business Mailing Address
First Line : PO BOX 45923
Second Line :
City : BALTIMORE
State : MD
Zip : 21297-5923
Country : US
Telephone Number : 877-969-0392
Fax Number : 804-658-0582
Provider Business Practice Location Address
First Line : 6161 KEMPSVILLE CIR STE 130
Second Line :
City : NORFOLK
State : VA
Zip : 23502-3932
Country : US
Telephone Number : 757-455-5130
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2015
Last Update Date : 03/05/2026

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Directions to “ SARA DE LA ROSA M.D.” Practice Location

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