Basic Information
| Provider Information | |||||||||
| NPI: | 1295043495 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JANNUZZIO | ||||||||
| FirstName: | ROSEANNA | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2605 W SWANN AVE | ||||||||
| Address2: | STE 100 | ||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336094039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8138745500 | ||||||||
| FaxNumber: | 8138745506 | ||||||||
| Practice Location | |||||||||
| Address1: | 6775 CROSSWINDS DR N | ||||||||
| Address2: | |||||||||
| City: | ST PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337105471 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273818006 | ||||||||
| FaxNumber: | 7273819629 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2010 | ||||||||
| LastUpdateDate: | 03/16/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/16/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA9105648 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.