Provider Demographics
NPI:1194355644
Name:CROUSE, ROSANNE MARTINO (RPH)
Entity type:Individual
Prefix:MRS
First Name:ROSANNE
Middle Name:MARTINO
Last Name:CROUSE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13508 N FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3213
Mailing Address - Country:US
Mailing Address - Phone:813-962-0768
Mailing Address - Fax:813-269-4550
Practice Address - Street 1:13508 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3213
Practice Address - Country:US
Practice Address - Phone:813-962-0768
Practice Address - Fax:813-269-4550
Is Sole Proprietor?:No
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0028539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist