1386519429 NPI number — ROSE ELIZABETH HAUSHEER MMT, MT-BC

Table of content: ROSE ELIZABETH HAUSHEER MMT, MT-BC (NPI 1386519429)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386519429 NPI number — ROSE ELIZABETH HAUSHEER MMT, MT-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAUSHEER
Provider First Name:
ROSE
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MMT, MT-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RITTER
Provider Other First Name:
ROSE
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MT-BC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386519429
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/21/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 120694
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MELBOURNE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32912-0694
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
321-209-1071
Provider Business Mailing Address Fax Number:
321-256-6424

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1906 PLATT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MELBOURNE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32901-4546
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-209-1071
Provider Business Practice Location Address Fax Number:
321-256-6424
Provider Enumeration Date:
10/08/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225A00000X , with the licence number:  13250 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 171W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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