Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | DN21025 | FL |
NPI | 1053701771 |
---|---|
Provider Name | Ashley Lynn Rosenbaum |
First Address | Miami, FL 33131-2551 |
Second Address | Miami, FL 33131-2551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2015 |
Last Update Date | 02/02/2015 |