Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | ME0056942 | FL |
NPI | 1629033253 |
---|---|
Provider Name | Mr. David Rosenberg |
First Address | Tampa, FL 33684-1637 |
Second Address | Tampa, FL 33603-2603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 11/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01424 | STAYWELL (01) | FL |
100789 | AVMED (01) | FL |
204478 | AMERIGROUP (01) | FL |
2414608 | AETNA (01) | FL |
752467 | FIRSTHEALTH (01) | FL |
F33317 | (02) |