Fredrieka Alicia Latoya Rose

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APRN9305674 Issued in FL

Practice address

5304 Mile Stretch Dr
Holiday, FL 34690-6060

Phone

(877) 202-1191

NPI assigned

Mar 21, 2024

Last updated

Mar 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1063272524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7751 NW 41ST ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330248415",
            "telephone_number": "954-643-0278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5304 MILE STRETCH DR",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "346906060",
            "telephone_number": "877-202-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "FREDRIEKA",
        "middle_name": "ALICIA LATOYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN9305674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kathleen Ann Rose-Le, MS CCC-SLP
• Adriana Sande, PHARM D
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• Peter Louis Scarano, DPT
• Dominicque Scott, RBT
• Serenity Behavioral Medicine LLC

• Adult Health Nurse Practitioner in Holiday, FL
• Providers in Holiday, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.