Healthcare Provider Details

I. General information

NPI: 1972437473
Provider Name (Legal Business Name): TWELVE ROSE MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 S OCEAN DR APT 2407
HALLANDALE BEACH FL
33009-7697
US

IV. Provider business mailing address

228 E ROUTE 59 STE 307
NANUET NY
10954-2905
US

V. Phone/Fax

Practice location:
  • Phone: 718-362-1411
  • Fax: 718-362-1651
Mailing address:
  • Phone: 877-258-6331
  • Fax: 718-362-1651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AARON J FEBUS
Title or Position: OWNER
Credential:
Phone: 718-362-1411