Provider Demographics
NPI:1316996788
Name:DESROSIERS, EVA (MD)
Entity type:Individual
Prefix:DR
First Name:EVA
Middle Name:
Last Name:DESROSIERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13250 SUNKISS LOOP
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-3158
Mailing Address - Country:US
Mailing Address - Phone:407-340-6078
Mailing Address - Fax:
Practice Address - Street 1:CONNECTICUT CHILDREN'S SPECIALTY GROUP, INC.
Practice Address - Street 2:282 WASHINGTON STREET
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106
Practice Address - Country:US
Practice Address - Phone:860-545-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94408207P00000X, 208M00000X
CT82597208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018865400Medicaid
FL275427400Medicaid