Individual
CARY ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 ZEAGLER DR STE 101, PALATKA, FL 32177-3860
(904) 493-3333
(904) 493-2222
Mailing address
PO BOX 551308, JACKSONVILLE, FL 32255-1308
(904) 622-9040
(904) 309-5690
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
37063
IA
207RC0000X
Cardiovascular Disease Physician
47083
MN
207RC0000X
Cardiovascular Disease Physician
P7558
TX
207RC0001X
Clinical Cardiac Electrophysiology Physician
37063
IA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
MD2022-0044
NM
207RC0001X
Clinical Cardiac Electrophysiology Physician
ME138201
FL
207RC0001X
Clinical Cardiac Electrophysiology Physician
P7558
TX
2085R0202X
Diagnostic Radiology Physician
P7558
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024064800
—
MN
05
—
0740571
—
IA
05
—
105189400
—
FL
05
—
34679800
—
WI
Enumeration date
12/06/2005
Last updated
05/10/2022
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