Crystal Rose, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA20372 Issued in FL

Practice address

1483 SW Bougainvillea Ave
Port St Lucie, FL 34953-7302

Phone

(772) 337-4208

NPI assigned

Aug 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1336814722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 SW GENERAL PATTON TER",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349532657",
            "telephone_number": "772-607-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1483 SW BOUGAINVILLEA AVE",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349537302",
            "telephone_number": "772-337-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "CRYSTAL",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA20372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HEALTH - LICENSE",
            "identifier": "SA20372",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kassandra Rosa
• Marlene Rosano
• Milton Angel Rosario, DPM
• Rose Assisted Living Facility, LLC.
• Amoya Dene Rose, RBT
• Emma Catherine Rose
• Jill Rosemont, LCSW
• Seth David Rosen, MD
• Scott Randall Rosenberg, D.M.D.
• Rosewood Garden of Port St.Lucie

• Speech-Language Pathologist in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.