Individual
MERCEDES ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6000 S RIO GRANDE AVE STE 102, ORLANDO, FL 32809-4650
(407) 982-7718
Mailing address
5002 HAINES CIR, ORLANDO, FL 32822-1712
(407) 515-0809
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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