Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | ME76245 | FL |
NPI | 1780680454 |
---|---|
Provider Name | Jason J Rosenberg |
First Address | Gainesville, FL 32607-2245 |
Second Address | Gainesville, FL 32607-2245 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 19/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H65704 | (02) | FL |