Provider Demographics
NPI:1811086275
Name:ROSENBERG, MICHAEL DENNIS (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DENNIS
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7015 BERACASA WAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3453
Mailing Address - Country:US
Mailing Address - Phone:561-394-0944
Mailing Address - Fax:561-394-9166
Practice Address - Street 1:7015 BERACASA WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3453
Practice Address - Country:US
Practice Address - Phone:561-394-0944
Practice Address - Fax:561-394-9166
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T78768Medicare UPIN
FL88317BMedicare ID - Type Unspecified