Rosa Daisy Maytin, APRN
Individual provider Active NPI Family Nurse Practitioner · Jacksonville, FL
NPI 1972068708 · NPPES record last updated Feb 23, 2024
Key facts
- NPI
- 1972068708
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN11001051 (FL)
- Practice address
- 1100 Cesery Blvd
Jacksonville, FL 32211-5674 - Phone
- (904) 551-5884
- NPI assigned
- Feb 6, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Solantic of Jacksonville LLC
Practice addresses (Care Compare)
1021 Cesery Blvd
Jacksonville, FL 32211-5609
Phone (615) 600-4074
12303 San Jose Blvd
Jacksonville, FL 32223-2640
Phone (615) 600-4074
1708 Blanding Blvd
Middleburg, FL 32068-3836
Phone (615) 600-4074
2140 Kingsley Ave
Orange Park, FL 32073-5180
Phone (615) 600-4074
2401 Monument Rd
Jacksonville, FL 32225-2520
Phone (904) 642-0337
410 Atlantic Blvd
Neptune Beach, FL 32266-4022
Phone (615) 600-4074
9680 Argyle Forest Blvd
Suite 34
Jacksonville, FL 32222-2847
Phone (904) 569-7771
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190411001984 | FL | Practitioner - Nurse Practitioner | 7416298872 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11001051 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Universal Kidney Care LLC | Current |
Accepting new patients | |
| Hni Medical Services of Florida, LLC | Current |
Accepting new patients | |
| Solantic of Jacksonville, LLC | Current |
Accepting new patients | |
| Resources for Mental Wellness LLC | Current |
Accepting new patients | |
| Maytin Integrated Healthcare, Inc | Current | Accepting new patients | |
| American Care of North Florida, Inc | Past |
Accepting new patients | |
| Solantic of Jacksonville, LLC | Past |
Accepting new patients |
Locations
10175 Fortune Pkwy
Unit 302
Jacksonville, FL 32256
Phone (904) 491-2160
4201 Belfort Rd
Jacksonville, FL 32216
Phone (904) 268-5561
1 Shircliff Way
Jacksonville, FL 32204
Phone (904) 332-0414
4190 Belfort Rd
Ste 130
Jacksonville, FL 32216
Phone (904) 252-7941
2401 Monument Rd
Jacksonville, FL 32225
Phone (904) 642-0337
10752 Deerwood Park Blvd
Ste 100
Jacksonville, FL 32256
Phone (407) 953-9734
463941 State Road 200
Yulee, FL 32097
Phone (904) 572-1959
7500 Rialto Blvd
Ste 1-140
Austin, TX 78735
7500 Rialto Blvd
Ste 1140
Austin, TX 78735
Phone (312) 385-0441
Interoperability endpoints
- rosa.maytin.1@29383.direct.athenahealth.com
- rosa.maytin.1@19860.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN11001051 | FL | Yes |
Addresses
Primary practice location
1100 Cesery Blvd
Jacksonville, FL 32211-5674
Mailing address
12171 SW 268TH St
Homestead, FL 33032-8001
Phone (305) 278-0200
Other providers in Jacksonville, FL
- Anthony Lamar Mays
- Jason Mays
- Sandrikas Mays
- Teia Mays
- Maytin Integrated Healthcare, Inc
- Regina Michelle Mayweather
- Linda Russell Maywood
- Kah'Muria T Mayze
- George Grant Mayzell
- Kentisha Mazeke
All providers in Jacksonville, FL · Family Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.