MEDICARE: DR. ADRIAN ROSE DDS

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	122300000X	Dentist	9959	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9959	OTHER	FL	STATE OF FLORIDA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497734438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADRIAN ROSE DDS

Provider Business Mailing Address
First Line	:	6156 NW 31ST CT
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33496-3318
Country	:	US
Telephone Number	:	561-542-1400
Fax Number	:

Provider Business Practice Location Address
First Line	:	6156 NW 31ST CT
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33496-3318
Country	:	US
Telephone Number	:	561-542-1400
Fax Number	:

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	04/05/2011

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