Healthcare Provider Details

I. General information

NPI: 1972555217
Provider Name (Legal Business Name): JEFFREY BRUCE ROSEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 MINORCA AVE, 2ND FLOOR PRIMECARE OF CORAL GABLES
CORAL GABLES FL
33134
US

IV. Provider business mailing address

370 MINORCA AVE FL 2
CORAL GABLES FL
33134-4321
US

V. Phone/Fax

Practice location:
  • Phone: 305-443-3001
  • Fax: 305-441-9427
Mailing address:
  • Phone: 305-443-3001
  • Fax: 786-235-8575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME40205
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: