MEDICARE: SHERYL ROSIN PHD, LLC

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	261QH0700X	Hearing and Speech Clinic/Center	SA10131	FL

General Provider Information

NPI Number	:	1295212264
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHERYL ROSIN PHD, LLC

Provider Business Mailing Address
First Line	:	3450 NORTHLAKE BLVD STE 203
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33403-1711
Country	:	US
Telephone Number	:	561-842-8996
Fax Number	:	561-842-8996

Provider Business Practice Location Address
First Line	:	3450 NORTHLAKE BLVD STE 203
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33403-1711
Country	:	US
Telephone Number	:	561-842-8996
Fax Number	:	561-842-8996

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	DR. SHERYL ROSIN
Credential	:	PHD
Telephone Number	:	561-842-8996

Provider Enumeration Date	:	07/23/2018
Last Update Date	:	07/23/2018

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