MEDICARE: MARC C ROSE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	ME 48626	FL
2	208800000X	Urology Physician	ME48626	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P02682780	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	31193	OTHER	FL	FL BLUE
2	88244226132960A003	OTHER		TRICARE - MILITARY

General Provider Information

NPI Number	:	1285632760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC C ROSE MD

Provider Business Mailing Address
First Line	:	PO BOX 644373
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32964-4373
Country	:	US
Telephone Number	:	772-564-1799
Fax Number	:	772-494-1975

Provider Business Practice Location Address
First Line	:	49 ROYAL PALM PT STE 100
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-4270
Country	:	US
Telephone Number	:	772-564-1799
Fax Number	:	772-494-1975

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	04/04/2023

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Directions to “ MARC C ROSE MD” Practice Location

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