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NPI Code Detail

MEDICARE: MS. KRISTEN MARIE ROTHENBERG PA-C

MEDICARE:  MS. KRISTEN MARIE ROTHENBERG  PA-C
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
1363AS0400XSurgical Physician AssistantPA9109068FL

Other Identifiers

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

General Provider Information

NPI Number : 1588037865
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTEN MARIE ROTHENBERG PA-C
Provider Business Mailing Address
First Line : 2734 SW 37TH AVE
Second Line :
City : COCONUT GROVE
State : FL
Zip : 33133-2728
Country : US
Telephone Number : 305-642-4263
Fax Number :
Provider Business Practice Location Address
First Line : 2734 SW 37TH AVE
Second Line :
City : COCONUT GROVE
State : FL
Zip : 33133-2728
Country : US
Telephone Number : 305-642-4263
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2015
Last Update Date : 06/19/2021

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Directions to “ MS. KRISTEN MARIE ROTHENBERG PA-C” Practice Location

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