Provider Demographics
NPI:1215323100
Name:IANIRO, ROSANNA ELENA (MD)
Entity type:Individual
Prefix:
First Name:ROSANNA
Middle Name:ELENA
Last Name:IANIRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 S. GULPH RD
Mailing Address - Street 2:ATTN: IPM CREDENTIALING
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3121
Mailing Address - Country:US
Mailing Address - Phone:941-722-7785
Mailing Address - Fax:
Practice Address - Street 1:606 4TH AVE W
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-5226
Practice Address - Country:US
Practice Address - Phone:941-722-7785
Practice Address - Fax:941-729-5267
Is Sole Proprietor?:No
Enumeration Date:2015-04-08
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME139461207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine