Provider Demographics
NPI:1427422724
Name:ROSELLO, RODNEY (ARNP AGACNP-BC)
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:
Last Name:ROSELLO
Suffix:
Gender:M
Credentials:ARNP AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 9TH ST N STE 100
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5886
Mailing Address - Country:US
Mailing Address - Phone:239-624-8250
Mailing Address - Fax:239-430-7824
Practice Address - Street 1:311 9TH ST N STE 100
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5886
Practice Address - Country:US
Practice Address - Phone:239-624-8250
Practice Address - Fax:239-430-7824
Is Sole Proprietor?:No
Enumeration Date:2015-11-24
Last Update Date:2017-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9310119363L00000X, 363LC0200X, 363LA2100X
FL9310119363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016263400Medicaid
FL4QVJSOtherBCBS
FLIK260ZOtherMEDICARE
FLIK260ZMedicare PIN