Healthcare Provider Details

I. General information

NPI: 1881782514
Provider Name (Legal Business Name): WILLIAM ROSENSTEIN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 09/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 S BARFIELD HWY
PAHOKEE FL
33476-1876
US

IV. Provider business mailing address

6650 W INDIANTOWN RD SUITE #110
JUPITER FL
33458-4628
US

V. Phone/Fax

Practice location:
  • Phone: 561-924-5155
  • Fax: 561-924-5155
Mailing address:
  • Phone: 561-575-9876
  • Fax: 561-575-2858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS 6379
License Number StateFL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier375161900
Identifier TypeMEDICAID
Identifier StateFL
Identifier Issuer
# 2
Identifier80934
Identifier TypeOTHER
Identifier StateFL
Identifier IssuerBCBS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: