Provider Demographics
NPI:1497177208
Name:ROSEBORO, RUKIYA (APRN)
Entity type:Individual
Prefix:
First Name:RUKIYA
Middle Name:
Last Name:ROSEBORO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5935 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-3501
Mailing Address - Country:US
Mailing Address - Phone:813-782-7778
Mailing Address - Fax:813-782-2361
Practice Address - Street 1:5935 7TH ST
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-3501
Practice Address - Country:US
Practice Address - Phone:813-782-7778
Practice Address - Fax:813-782-2361
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9192057363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010918600Medicaid