Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS3389 | FL |
Y | 208000000X | Pediatrician | OS3389 | FL |
NPI | 1184650004 |
---|---|
Provider Name | Dr. Stanley Alan Rosenthal |
First Address | Tampa, FL 33613 |
Second Address | Tampa, FL 33613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 26/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
057258600 | (05) | FL |
D60595 | (02) |