MEDICARE: MR. JEFFREY ALAN ROSENKER CRNA

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	367500000X	Certified Registered Nurse Anesthetist	0000	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356346811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY ALAN ROSENKER CRNA

Provider Business Mailing Address
First Line	:	1495 S FEDERAL HWY
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-6003
Country	:	US
Telephone Number	:	407-670-9765
Fax Number	:

Provider Business Practice Location Address
First Line	:	1495 S FEDERAL HWY
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-6003
Country	:	US
Telephone Number	:	407-670-9765
Fax Number	:

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	12/26/2014

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