Active NPI
Rosenie Ezai-Gilles
- Clinical Social Worker
- Wilton Manors, FL
National Provider Identifier
1154924728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 16978
- Practice address
- 2225 N Andrews Ave
Wilton Manors, FL 33311-3922 - Phone
- (954) 951-5848
- NPI assigned
- Nov 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 16978 | FL | Primary |
Addresses
Primary practice location
2225 N Andrews Ave
Wilton Manors, FL 33311-3922
Mailing address
200 NE 10TH St
Pompano Beach, FL 33060-5786
Phone (954) 951-5848
Other names 1
- Rosenie Ezai
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16978 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721692800000",
"number": "1154924728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 NE 10TH ST",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330605786",
"telephone_number": "954-951-5848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 N ANDREWS AVE",
"city": "WILTON MANORS",
"state": "FL",
"postal_code": "333113922",
"telephone_number": "954-951-5848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZAI-GILLES",
"first_name": "ROSENIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-17",
"last_updated": "2024-07-23",
"certification_date": "2024-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "16978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ROSENIE",
"last_name": "EZAI",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Wilton Manors, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.