Individual
DR. ROSA A. VIDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2432 67TH AVE S, ST PETERSBURG, FL 33712-5613
(251) 454-1126
(727) 528-6452
Mailing address
2432 67TH AVE S, ST PETERSBURG, FL 33712-5613
(251) 454-1126
(727) 528-6452
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
24595
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125518
—
MS
05
—
009981610
—
AL
05
—
1699098
—
LA
05
—
263997100
—
FL
01
—
39-00626
UNITED HEALTHCARE
AL
01
—
51507738
BCBS
AL
01
—
ME135633
FLORIDA BOARD OF MEDICINE
FL
Enumeration date
06/07/2006
Last updated
07/09/2024
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