Individual
IVELISSE ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
340 HEALD WAY BLDG 100, THE VILLAGES, FL 32163-6087
(352) 259-1919
Mailing address
340 HEALD WAY BLDG 100, THE VILLAGES, FL 32163-6087
(352) 259-1919
(352) 259-2042
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
25MD00288300
NJ
213ES0131X
Foot Surgery Podiatrist
N006138
NY
Other
Enumeration date
10/15/2006
Last updated
02/08/2024
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