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General NPI Number Information
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NPI Number | 1821269762
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Entity Type | Individual
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Provider Name | WAYNE R ROSEN CPO, CPED,PA
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Gender | Male
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Dates
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Enumeration Date | 03/19/2008
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 9921 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6174
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Country | US
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Telephone | 954-447-7779
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Fax | 954-447-7782
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Provider Business Mailing Address
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Address Line | 9921 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6174
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Country | US
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Telephone | 954-447-7779
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Fax | 954-447-7782
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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 | 222Z00000X
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Taxonomy Name | Orthotist
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License Number | PO 00039
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 224P00000X
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Taxonomy Name | Prosthetist
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License Number | PO 00039
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License Number State | FL
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