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General NPI Number Information
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NPI Number | 1881920569
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Entity Type | Organization
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Legal Business Name | RICHARD M ROSEN, DO, PA
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Dates
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Enumeration Date | 10/30/2009
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Last Update Date | 10/30/2009
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Provider Practice Location Address
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Address Line | 9900 STIRLING ROAD SUITE 102
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City | COOPER CITY
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State | FL
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Zip | 33024
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Country | US
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Telephone | 954-322-2245
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Fax | 954-322-2248
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Provider Business Mailing Address
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Address Line | 9900 STIRLING ROAD SUITE 102
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City | COOPER CITY
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State | FL
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Zip | 33024
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Country | US
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Telephone | 954-322-2245
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Fax | 954-322-2248
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD M ROSEN
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Credential | D.O.
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Telephone | 954-322-2245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS3685
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License Number State | FL
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