Healthcare Provider Details

I. General information

NPI: 1710490792
Provider Name (Legal Business Name): SANDRA ROSENBERG ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2017
Last Update Date: 04/20/2024
Certification Date: 04/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 NW 14TH ST
MIAMI FL
33136
US

IV. Provider business mailing address

1150 NW 14TH ST
MIAMI FL
33136-2137
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6090
  • Fax:
Mailing address:
  • Phone: 305-243-6090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9327557
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number9327557
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: