Provider Demographics
NPI:1265307128
Name:DE LA ROSA, KATHELEIN (RN)
Entity type:Individual
Prefix:
First Name:KATHELEIN
Middle Name:
Last Name:DE LA ROSA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N BAYSHORE DR APT 2909
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-3231
Mailing Address - Country:US
Mailing Address - Phone:305-582-0139
Mailing Address - Fax:305-582-0139
Practice Address - Street 1:2915 BISCAYNE BLVD STE 214
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-4197
Practice Address - Country:US
Practice Address - Phone:786-671-2525
Practice Address - Fax:786-671-2525
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9535485163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse