MEDICARE: DR. ELIZABETH GAYE ROSEN 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	207QA0505X	Adult Medicine Physician	ME 80973	FL

General Provider Information

NPI Number	:	1659588325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH GAYE ROSEN M.D.

Provider Business Mailing Address
First Line	:	8501 VERESE CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32836-8755
Country	:	US
Telephone Number	:	407-996-2845
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 TURKEY LAKE RD STE 209
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-4206
Country	:	US
Telephone Number	:	407-648-5252
Fax Number	:

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

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	07/08/2007

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