Provider Demographics
NPI:1104515170
Name:ROSSI, MATTHEW FRANCES (APRN)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:FRANCES
Last Name:ROSSI
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 N DIXIE FWY STE 1
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA
Mailing Address - State:FL
Mailing Address - Zip Code:32168-6200
Mailing Address - Country:US
Mailing Address - Phone:386-423-0505
Mailing Address - Fax:386-423-0515
Practice Address - Street 1:1055 N DIXIE FWY STE 1
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA
Practice Address - State:FL
Practice Address - Zip Code:32168-6200
Practice Address - Country:US
Practice Address - Phone:386-423-0505
Practice Address - Fax:386-423-0515
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9369727363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner