Healthcare Provider Details

I. General information

NPI: 1366405912
Provider Name (Legal Business Name): DAVID W ROSENBAUM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 NW 14TH ST SUITE 200
MIAMI FL
33125-1673
US

IV. Provider business mailing address

1321 NW 14TH STREET SUITE 200
MIAMI FL
33125
US

V. Phone/Fax

Practice location:
  • Phone: 305-324-0220
  • Fax: 305-545-0790
Mailing address:
  • Phone: 305-324-0220
  • Fax: 305-545-0790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME0032991
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: