=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639113152
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MURRAY ROSENBAUM M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2006
-----------------------------------------------------
Last Update Date | 04/21/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1200 N FEDERAL HWY SUITE 100
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33432-2803
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-266-0190
-----------------------------------------------------
Fax | 561-300-3250
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1200 N FEDERAL HWY SUITE 100
-----------------------------------------------------
City | BOCA RATON
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33432-2803
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-266-0190
-----------------------------------------------------
Fax | 561-300-3250
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0001X
-----------------------------------------------------
Taxonomy Name | Clinical Cardiac Electrophysiology Physician
-----------------------------------------------------
License Number | ME0071991
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------