Provider Demographics
NPI:1902492127
Name:CUPOLI, ROSEANNE (MSW, MPH)
Entity Type:Individual
Prefix:
First Name:ROSEANNE
Middle Name:
Last Name:CUPOLI
Suffix:
Gender:F
Credentials:MSW, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5905 N DEXTER AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-6501
Mailing Address - Country:US
Mailing Address - Phone:813-404-4353
Mailing Address - Fax:
Practice Address - Street 1:5905 N DEXTER AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-6501
Practice Address - Country:US
Practice Address - Phone:813-404-4353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker