Individual provider · Type 1 NPI

Lacey Elissa Rose, PA

Physician Assistant · Sarasota, FL

NPI number 1629839709 Active

Practice location

1700 S Tamiami Trl
Sarasota, FL 34239-3509

Call (941) 917-7494 Map

Fax (941) 917-7739

Mailing address

PO Box 947407
Atlanta, GA 30394-7407

Other practice locations

  • 527 Bay Rd Ste 7, Queensbury, NY 12804-1430 · (215) 585-2144
  • 18 E 41st St Fl 14, New York, NY 10017-6244 · (215) 585-2144
  • 301 E Main St, Bay Shore, NY 11706-8408 · (631) 968-3000

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X031360 (NY)
Surgical Physician Assistant 363AS0400X031360 (NY)
Surgical Physician Assistant 363AS0400XPA9120077 (FL)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1629839709

Lacey Elissa Rose, PA's National Provider Identifier is 1629839709, issued on Jan 17, 2024. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Sarasota, FL. The record was last updated on Oct 9, 2026.