Provider Demographics
NPI:1386790566
Name:ROSEN, FLOYD L (MD)
Entity type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:L
Last Name:ROSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 SW 57TH AVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5522
Mailing Address - Country:US
Mailing Address - Phone:305-665-5644
Mailing Address - Fax:
Practice Address - Street 1:7900 SW 57TH AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5522
Practice Address - Country:US
Practice Address - Phone:305-665-5644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0011318174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL13838Medicare ID - Type Unspecified