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General NPI Number Information
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NPI Number | 1467667097
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Entity Type | Organization
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Legal Business Name | MARVIN S. ROSENBLATT, PH.D., P.A.
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6203 WEST COMMERCIAL BOULEVARD
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City | FT.LAUDERDALE
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State | FL
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Zip | 33319
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Country | US
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Telephone | 954-722-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 6203 WEST COMMERCIAL BOULEVARD
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City | FT.LAUDERDALE
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State | FL
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Zip | 33319
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Country | US
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Telephone | 954-722-2020
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARVIN S. ROSENBLATT
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Credential | PH.D.
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Telephone | 954-722-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY 2555
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License Number State | FL
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