Rose, Phyllis Theresa

Rose, Phyllis Theresa is an individual health care provider with primary practice located at 7406 Fullerton St Ste 200 , Jacksonville FL 32256-3597. She recently has only one registered license in Nursing Service Related Providers / Nurse's Aide, which is considered as her primary health care specialty. Rose, Phyllis Theresa can be contacted via phone (904) 538-0440.

Contact Information

Primary practice address
7406 Fullerton St Ste 200 Jacksonville FL 32256-3597
Phone: (904) 538-0440
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Nurse's Aide 376K00000X Florida

Profile Details

NPI number 1801324454
LBN Legal business name Rose, Phyllis Theresa
Credentials NA
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2017
Last updated May 26th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801324454 NPPES
Florida MEDICAID HW806A

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