Provider Demographics
NPI:1174301923
Name:CASO, ROSALIE
Entity type:Individual
Prefix:
First Name:ROSALIE
Middle Name:
Last Name:CASO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11850 MARTIN LUTHER KING ST N APT 18306
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-1638
Mailing Address - Country:US
Mailing Address - Phone:760-533-2857
Mailing Address - Fax:
Practice Address - Street 1:1514 E CHELSEA ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-6114
Practice Address - Country:US
Practice Address - Phone:813-238-6406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ11748.235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist