Individual
DR. CIELO ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1264 METROPOLITAN BLVD, TALLAHASSEE, FL 32312-2536
(850) 523-7410
Mailing address
PO BOX 15349, TALLAHASSEE, FL 32317-5349
(850) 523-7410
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS13265
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015041300
—
FL
01
—
150KJ
FL BLUE
FL
Enumeration date
03/30/2015
Last updated
05/20/2021
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