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CRISTA MARINA ANA LUCIA ROSBOROUGH ATC, LAT

>> Specialist >> Other Service Providers

Registrant NPI Number: 1073968715

Individual Registrant:
 CRISTA MARINA ANA LUCIA ROSBOROUGH ATC, LAT
Gender: F
Sole Proprietor

Location and contact information for practice:
21403 SE 70TH AVE  HAWTHORNE, FL 32640 US
Tel: 412-477-9382  Fax: --

Contact information for business:
701 SW 62ND BLVD APT 90  GAINESVILLE, FL 32607-2078 US
Tel: 412-477-9382  Fax: --

Registration Information:
NPI: 1073968715
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y174400000XOther Service Providers
Specialist
FLAL4275

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCEAL4275FL01




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