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General NPI Number Information
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NPI Number | 1164846911
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Entity Type | Organization
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Legal Business Name | PABLO ROSEMBERG LLC
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Dates
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Enumeration Date | 02/14/2014
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Last Update Date | 02/14/2014
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Provider Practice Location Address
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Address Line | 5447 INTERNATIONAL DR
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City | ORLANDO
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State | FL
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Zip | 32819-8567
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Country | US
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Telephone | 407-248-8334
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Fax | 407-248-8338
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Provider Business Mailing Address
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Address Line | 5447 INTERNATIONAL DR
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City | ORLANDO
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State | FL
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Zip | 32819-8567
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Country | US
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Telephone | 407-248-8334
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Fax | 407-248-8338
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Authorized Official
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Title or Position | CEO
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Name | MR. PABLO ROSEMBERG
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Credential |
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Telephone | 407-354-3939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | OE2046
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License Number State | FL
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