Basic Information
| Provider Information | |||||||||
| NPI: | 1871784991 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RIVERA DE ROSALES | ||||||||
| FirstName: | ANABELEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2995 DREW ST FL 2 | ||||||||
| Address2: | |||||||||
| City: | CLEARWATER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337593012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275321355 | ||||||||
| FaxNumber: | 8136352613 | ||||||||
| Practice Location | |||||||||
| Address1: | 3001 W DR MARTIN LUTHER KING JR BLVD FL 3 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336076307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8138704933 | ||||||||
| FaxNumber: | 8138704887 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2007 | ||||||||
| LastUpdateDate: | 07/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD.202112 | LA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | ME111664 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | ME111664 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 208M00000X | MD.202112 | LA | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | ME111664 | FL | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 09527229 | 05 | MS | MEDICAID | 1091367 | 05 | LA | MEDICAID | 005819800 | 05 | FL | MEDICAID |