Provider Demographics
NPI:1053145177
Name:ROSARIO, ROSELINE (MD, IBCLC)
Entity type:Individual
Prefix:
First Name:ROSELINE
Middle Name:
Last Name:ROSARIO
Suffix:
Gender:F
Credentials:MD, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2317 S LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-3648
Mailing Address - Country:US
Mailing Address - Phone:407-575-5024
Mailing Address - Fax:
Practice Address - Street 1:2317 S LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-3648
Practice Address - Country:US
Practice Address - Phone:407-575-5024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-30
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL21776163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant