Healthcare Provider Details

I. General information

NPI: 1437351020
Provider Name (Legal Business Name): ISRAEL ROSENZWEIG MSW, LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 W CAMINO REAL STE 205
BOCA RATON FL
33432-5966
US

IV. Provider business mailing address

2191 NE 5TH AVE
BOCA RATON FL
33431-7610
US

V. Phone/Fax

Practice location:
  • Phone: 561-801-2448
  • Fax: 561-840-4137
Mailing address:
  • Phone: 561-801-2448
  • Fax: 561-840-4137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 4742
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: