Individual provider Active NPI

Jezel E Rosa, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Sebastian, FL
National Provider Identifier
1174810659
Registry record updated Jan 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11013721 Issued in FL
Practice address
9611 N US Highway 1 # 363
Sebastian, FL 32958-6363
Phone
(786) 751-2082
Fax
(786) 590-1944
NPI assigned
Jul 5, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2026

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

Specialties & licenses 12

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95406221 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP002610 GA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 72029 NM
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP031881 PA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1197802 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 51503 WY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP70009299 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN.CNP.0040663 OH
Registered Nurse 163W00000X 9386197 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95034679 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 30145 TN
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11013721 FL Primary

Addresses

Primary practice location

9611 N US Highway 1 # 363
Sebastian, FL 32958-6363

Mailing address

9611 N US Highway 1 # 363
Sebastian, FL 32958-6363
Phone (786) 751-2082

Other identifiers 3

IdentifierTypeStateIssuer
RN 9386197OtherFLRN LICENSE
PMHNP-BC2021032994OtherFLANCC
APRN11013721OtherFLFLORIDA DEPARTMENT OF HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220427001571 FL Order and Referring Only - Nurse Practitioner 9537556204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95406221CAMDRegistered Nurse
9386197FLMDRegistered Nurse
95034679CAMDPsychiatric/Mental Health Nurse Practitioner
APRN11013721FLMDPsychiatric/Mental Health Nurse Practitioner
NP002610GAMDPsychiatric/Mental Health Nurse Practitioner
72029NMMDPsychiatric/Mental Health Nurse Practitioner
APRN.CNP.0040663OHMDPsychiatric/Mental Health Nurse Practitioner
SP031881PAMDPsychiatric/Mental Health Nurse Practitioner
30145TNMDPsychiatric/Mental Health Nurse Practitioner
1197802TXMDPsychiatric/Mental Health Nurse Practitioner
AP70009299WAMDPsychiatric/Mental Health Nurse Practitioner
51503WYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767225600000",
    "number": "1174810659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9611 N US HIGHWAY 1 # 363",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329586363",
            "telephone_number": "786-751-2082",
            "fax_number": "786-590-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9611 N US HIGHWAY 1 # 363",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329586363",
            "telephone_number": "786-751-2082",
            "fax_number": "786-590-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSA",
        "first_name": "JEZEL",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2026-01-01",
        "certification_date": "2026-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95406221",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "NP002610",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "72029",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP031881",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1197802",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WY",
            "license": "51503",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP70009299",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "APRN.CNP.0040663",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9386197",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95034679",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "30145",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11013721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN 9386197",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANCC",
            "identifier": "PMHNP-BC2021032994",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "APRN11013721",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

Verify at the official NPI Registry.