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Provider Information for 1396803615

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

ROSEMAY T LATORTUE M.D.

Gender: FEMALE

Individual NPI: 1396803615

Calendar   Last Updated:  2012-02-01
  Certification Date: 

Details

Name Value
NPI 1396803615
Enumeration Date 2006-12-06
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 8751 N 30TH ST
TAMPA, FL 33604-2213
United States

Phone: 813-980-2422 | Fax: 813-980-2204
View Map External Link
Primary Practice Address 8751 N 30TH ST
TAMPA, FL 33604-2213
United States

Phone: 813-980-2422 | Fax: 813-980-2204
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
MEDICAID FL 1D048748100
Other TIN FL 593159976
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207R00000X - Internal Medicine FL ME0050777