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NPI Code Detail

MEDICARE: DR. JON NELSON ROSENTHAL DO

MEDICARE: DR. JON NELSON ROSENTHAL DO
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
1207YS0123XFacial Plastic Surgery Physician6800FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10546175002OTHERFLCIGNA
20853275OTHERFLAETNA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1831183581
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JON NELSON ROSENTHAL DO
Provider Business Mailing Address
First Line : 220 SW 84TH AVE
Second Line : SUITE 101
City : PLANTATION
State : FL
Zip : 33324-2754
Country : US
Telephone Number : 954-796-0400
Fax Number : 954-753-6673
Provider Business Practice Location Address
First Line : 220 SW 84TH AVE
Second Line : SUITE 101
City : PLANTATION
State : FL
Zip : 33324-2754
Country : US
Telephone Number : 954-796-0400
Fax Number : 954-753-6673
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 07/08/2007

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Directions to “ DR. JON NELSON ROSENTHAL DO” Practice Location

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