Basic Information
| Provider Information | |||||||||
| NPI: | 1255057360 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANZALONE | ||||||||
| FirstName: | ROSINA | ||||||||
| MiddleName: | ANGELINA | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7384 ROYAL OAK DR | ||||||||
| Address2: | |||||||||
| City: | SPRING HILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346072339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522389343 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 659 NE HIGHWAY 19 UNIT 1, NORTH SUNCOAST BOULEVARD | ||||||||
| Address2: | |||||||||
| City: | CRYSTAL RIVER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34429 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3525630911 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2022 | ||||||||
| LastUpdateDate: | 10/19/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA9116635 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.