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General NPI Number Information
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NPI Number | 1487098059
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Entity Type | Individual
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Provider Name | JASON R ROSEN D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2013
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Last Update Date | 07/03/2019
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Provider Practice Location Address
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Address Line | 4675 LINTON BLVD STE 203B
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City | DELRAY BEACH
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State | FL
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Zip | 33445-6615
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Country | US
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Telephone | 561-499-5341
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Fax | 561-499-5343
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Provider Business Mailing Address
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Address Line | 4675 LINTON BLVD STE 203B
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City | DELRAY BEACH
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State | FL
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Zip | 33445-6615
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Country | US
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Telephone | 561-499-5341
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Fax | 561-499-5343
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZD0900X
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Taxonomy Name | Dermatopathology (Pathology) Physician
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License Number | OS14613
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | OS14613
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | OS14613
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License Number State | FL
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