Individual
CRISTA MARINA ANA LUCIA ROSBOROUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
21403 SE 70TH AVE, HAWTHORNE, FL 32640
(412) 477-9382
Mailing address
701 SW 62ND BLVD APT 90, GAINESVILLE, FL 32607-2078
(412) 477-9382
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AL4275
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL4275
DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE
FL
Enumeration date
05/02/2016
Last updated
05/02/2016
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