MEDICARE: DR. KENNETH R ROSENTHAL 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	207RG0100X	Gastroenterology Physician	ME42231	FL

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	:	1922002781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH R ROSENTHAL M.D.

Provider Business Mailing Address
First Line	:	5431 N UNIVERSITY DR
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-4639
Country	:	US
Telephone Number	:	954-344-2522
Fax Number	:	954-344-9189

Provider Business Practice Location Address
First Line	:	9970 CENTRAL PARK BLVD N
Second Line	:	STE 101
City	:	BOCA RATON
State	:	FL
Zip	:	33428-2231
Country	:	US
Telephone Number	:	561-488-2700
Fax Number	:	561-488-1814

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	04/07/2016

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