Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0127X | Trauma Surgeon | 94918 | FL |
NPI | 1356351076 |
---|---|
Provider Name | Andrew Rosenthal |
First Address | Miramar, FL 33025-3925 |
Second Address | Hollywood, FL 33021-5431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 17/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
276294300 | (05) | FL |