MEDICARE: DR. LEON GUSTAV ROSENKRANZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	123694	FL
2	207R00000X	Internal Medicine Physician	128439	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	128439	OTHER	NY	NY STATE MEDICAL LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	123694	OTHER	FL	FLORIDA MEDICAL LICENSE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033114483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEON GUSTAV ROSENKRANZ M.D.

Provider Business Mailing Address
First Line	:	435 S GULFSTREAM AVE
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34236-6736
Country	:	US
Telephone Number	:	718-974-7518
Fax Number	:	718-273-9664

Provider Business Practice Location Address
First Line	:	435 S GULFSTREAM AVE
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34236-6736
Country	:	US
Telephone Number	:	718-974-7518
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	11/13/2019

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