Organization
RENNAY ROSE
Active
Organization
RENNAY ROSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RENNAY ANN TONJA ROSE BA (ITDS)
(954) 849-1117
Entity
Organization
Contact information
Practice address
203 SW 85TH TER, APT. 306, PEMBROKE PINES, FL 33025-4525
(954) 849-1117
Mailing address
203 SW 85TH TER, APT. 306, PEMBROKE PINES, FL 33025-4525
(954) 849-1117
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000512700
—
FL
Enumeration date
06/23/2010
Last updated
11/01/2011
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