Individual
ROSE ELIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5654 ROCK ISLAND RD, UNIT 217, TAMARAC, FL 33319-2886
(954) 484-7626
Mailing address
5654 ROCK ISLAND RD, UNIT 217, TAMARAC, FL 33319-2886
(954) 484-7626
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT12759
FL
Other
Enumeration date
10/29/2008
Last updated
10/29/2008
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