MEDICARE: KEITH ROSENBACH MD

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	207RI0200X	Infectious Disease Physician	ME74079	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00185961	OTHER	FL	RR MEDICARE

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	:	1851300172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEITH ROSENBACH MD

Provider Business Mailing Address
First Line	:	1344 HIGHWOOD PL
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-6760
Country	:	US
Telephone Number	:	133-092-3038
Fax Number	:

Provider Business Practice Location Address
First Line	:	1344 HIGHWOOD PL
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-6760
Country	:	US
Telephone Number	:	813-309-2303
Fax Number	:

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/07/2022

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