MEDICARE: JBS MEDICAL PA

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	174400000X	Specialist	ME89367	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7468622	OTHER		AETNA PROVIDER # FOR ANDREW ROSENTHAL, MD
2	27842	OTHER	FL	BCBS PROVIDER FOR ANDREW ROSENTHAL,MD
3	38257	OTHER		BCBS GROUP NUMBER
4	16548	OTHER	FL	BCBS NON-PAR PROVIDER # FOR MATTHEW GOODWIN, MD

General Provider Information

NPI Number	:	1639297468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JBS MEDICAL PA

Provider Business Mailing Address
First Line	:	7280 W PALMETTO PARK RD STE 305
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3401
Country	:	US
Telephone Number	:	561-393-8800
Fax Number	:	561-393-6202

Provider Business Practice Location Address
First Line	:	7280 W PALMETTO PARK RD STE 305
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3401
Country	:	US
Telephone Number	:	561-393-8800
Fax Number	:	561-393-6202

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ANDREW ROSENTHAL
Credential	:	MD
Telephone Number	:	561-393-8800

Provider Enumeration Date	:	03/27/2007
Last Update Date	:	06/06/2008

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Directions to “JBS MEDICAL PA ” Practice Location

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