Rebecca Penta Rose, | |
1901 Ne 9th St, Gainesville, FL 32609-3736 | |
(518) 860-2689 | |
Not Available |
Full Name | Rebecca Penta Rose |
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Gender | Female |
Speciality | Counselor - Mental Health |
Location | 1901 Ne 9th St, Gainesville, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588214753 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | IMH18386 (Florida) | Primary |
Entity Name | Grow Healthcare Group Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245845932 PECOS PAC ID: 3476961368 Enrollment ID: O20210414000053 |
Mailing Address | Practice Location Address |
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Rebecca Penta Rose, 4706 Nw 40th Ter, Gainesville, FL 32606-4444 Ph: () - | Rebecca Penta Rose, 1901 Ne 9th St, Gainesville, FL 32609-3736 Ph: (518) 860-2689 |
Roger Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4300 Sw 13th St, Gainesville, FL 32608 Phone: 352-374-5600 | |
Joseph Palmer, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4300 Sw 13th St, Gainesville, FL 32608 Phone: 352-374-5600 | |
Kelly Miller, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4300 Sw 13th St, Gainesville, FL 32608 Phone: 352-374-5600 Fax: 352-374-5608 | |
Shannon Moser, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4300 Sw 13th St, Gainesville, FL 32608 Phone: 352-374-5600 Fax: 352-374-5608 | |
Erica S Mosley, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4300 Sw 13th Street, Gainesville, FL 32608 Phone: 352-374-5600 | |
Kyeesha Williams, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4300 Sw 13th St, Gainesville, FL 32608 Phone: 352-374-5600 Fax: 352-374-5600 | |
Crystal Biggers, Counselor Medicare: Not Enrolled in Medicare Practice Location: 4300 Sw 13th St, Gainesville, FL 32608 Phone: 352-374-5600 |