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NPI Code Detail

MEDICARE: TODD J ROUSE PA

MEDICARE: TODD J ROUSE 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
1363A00000XPhysician AssistantPA9103893FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA 9103893OTHERFLPA LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700056272
Entity Type Code : Individual
Provider Name (Legal Business Name) : TODD J ROUSE PA
Provider Business Mailing Address
First Line : 6101 BLUE LAGOON DR STE 400
Second Line :
City : MIAMI
State : FL
Zip : 33126-2051
Country : US
Telephone Number : 305-500-2000
Fax Number :
Provider Business Practice Location Address
First Line : 9030 KIMBERLY BLVD
Second Line :
City : BOCA RATON
State : FL
Zip : 33434-2823
Country : US
Telephone Number : 561-488-2300
Fax Number : 561-487-6704
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2008
Last Update Date : 04/06/2026

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