Provider Demographics
NPI:1871745513
Name:MUSELLA, ROSARIO (MD)
Entity type:Individual
Prefix:
First Name:ROSARIO
Middle Name:
Last Name:MUSELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 66TH ST N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-5040
Mailing Address - Country:US
Mailing Address - Phone:727-343-0600
Mailing Address - Fax:727-344-6163
Practice Address - Street 1:6600 66TH ST N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-5040
Practice Address - Country:US
Practice Address - Phone:727-343-0600
Practice Address - Fax:727-344-6163
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0018297207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL047952700Medicaid
D70618Medicare UPIN
FL047952700Medicaid