Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME22511 | FL |
Y | 111NI0900X | Internist | ME22511 | FL |
N | 207RG0300X | Geriatric Medicine | ME22511 | FL |
NPI | 1144337262 |
---|---|
Provider Name | Dr. Stanley Allen Rosenberg |
First Address | Clearwater, FL 33757-1830 |
Second Address | South Pasadena, FL 33707-4559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 22/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
057160100 | (05) | FL |
D61217 | (02) | FL |
P01022905 | MEDICARE RAILROAD PROVIDER NUMBER (01) | FL |