Provider Demographics
NPI:1528115144
Name:ROSINO, ANGELA JEAN (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:JEAN
Last Name:ROSINO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23 ALAFAYA WOODS BLVD
Mailing Address - Street 2:SUITE 167
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-6233
Mailing Address - Country:US
Mailing Address - Phone:407-718-2924
Mailing Address - Fax:407-366-0044
Practice Address - Street 1:23 ALAFAYA WOODS BLVD
Practice Address - Street 2:SUITE 167
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-6233
Practice Address - Country:US
Practice Address - Phone:407-718-2924
Practice Address - Fax:407-366-0044
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA6979235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL888117100Medicaid
FL686083496Medicaid