Individual
CHAVELY DE LA ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7911 NW 72ND AVE, MEDLEY, FL 33166-2227
(484) 619-8220
Mailing address
10712 SW 44TH ST, MIAMI, FL 33165-4837
(484) 619-8220
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
11020251
FL
Other
Enumeration date
07/12/2022
Last updated
07/29/2022
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