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Provider Information for 1396816179

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

TREVOR ANTHONY ROSE MD

Gender: MALE

Individual NPI: 1396816179

Calendar   Last Updated:  2013-03-11
  Certification Date: 

Details

Name Value
NPI 1396816179
Enumeration Date 2006-11-13
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 6551 RIDGE RD SUITE 2
PORT RICHEY, FL 34668-6868
United States

Phone: 727-846-0666 | Fax: 727-849-1474
View Map External Link
Primary Practice Address 6551 RIDGE RD SUITE 2
PORT RICHEY, FL 34668-6868
United States

Phone: 727-846-0666 | Fax: 727-849-1474
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207R00000X - Internal Medicine FL ME60120