Individual
ROSE RACHELLE L NICOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 S FEDERAL HWY, FORT LAUDERDALE, FL 33316-2619
(954) 728-1115
(954) 779-2316
Mailing address
1401 S FEDERAL HWY, FORT LAUDERDALE, FL 33316-2619
(954) 728-1115
(954) 779-2316
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105597800
—
FL
Enumeration date
02/18/2020
Last updated
03/25/2020
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