E. GEORGE ROSANELLI, JR, MD, PA
Medical Practice at Dr Martin Luther King Jr Blvd, Tampa, FL

License number
Florida D85517
Category
Medical Practice
Type
Ophthalmology
Owner
Name: DR. EDWARD GEORGE ROSANELLI JR. MD
Title: PRESIDENT
Phone: (813) 875-3884
Address
Address
2129 W Dr Martin Luther King Jr Blvd, Tampa, FL 33607
National Provider ID: 1003013665
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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E. GEORGE ROSANELLI, JR., M.D., PA

4129 N Armenia Ave SUITE A, Tampa, FL 33607

Status:
Inactive
Doing business as:
E George Rosanelli Jr MD Pa
Inactive reason:
CANCEL ADM DISS/REV
Registration:
Mar 28, 1985
Inactive since:
May 20, 2010
Phone:
(813) 875-3884 (Phone)
State ID:
H49465
Business type:
Florida Profit Corporation
S:
E. George Rosanelli, 4129 N Armenia Ave SUITE A, Tampa, FL 33607 (Physical),Yvonne L Rosanelli, 4129 N Armenia Ave, Tampa, FL 33607 (Physical)
Agent:
E. Rosanelli,4129 N Armenia Ave SUITE A, Tampa, FL 33607 (Physical)
EIN:
592506678
Categories:
Physicians & Surgeons
Products:
Glaucoma & Related Diseases

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