Provider Demographics
NPI:1699235655
Name:DE CARVALHO, ROSA (MD)
Entity type:Individual
Prefix:
First Name:ROSA
Middle Name:
Last Name:DE CARVALHO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROSA
Other - Middle Name:
Other - Last Name:DE CARVALHO DE ARMAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1020 LAKE SUMTER LNDG
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-2699
Mailing Address - Country:US
Mailing Address - Phone:352-674-8905
Mailing Address - Fax:352-674-8901
Practice Address - Street 1:2910 BROWNWOOD BLVD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163-2032
Practice Address - Country:US
Practice Address - Phone:844-884-9355
Practice Address - Fax:352-674-8990
Is Sole Proprietor?:No
Enumeration Date:2019-03-24
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME152849207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program