Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | ME036327 | FL |
NPI | 1245225630 |
---|---|
Provider Name | Steven Rosenberg |
First Address | Winter Park, FL 32792-2285 |
Second Address | Winter Park, FL 32792-2285 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 03/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001565800 | (05) | FL |
47344 | BCBS (01) | FL |
D62498 | (02) |