Provider Demographics
NPI:1144068503
Name:ROSADO, STEPHANIE (NP)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:ROSADO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 STONEY POINT CIR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33896-7995
Mailing Address - Country:US
Mailing Address - Phone:407-346-5780
Mailing Address - Fax:
Practice Address - Street 1:1433 WP BALL BLVD STE 39
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-7206
Practice Address - Country:US
Practice Address - Phone:321-270-0640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11033731363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner