Provider Demographics
NPI:1003080292
Name:SEYMOUR R. ROSEN, M.D.P.A.
Entity Type:Organization
Organization Name:SEYMOUR R. ROSEN, M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SEYMOUR
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-272-4222
Mailing Address - Street 1:4591 BERKLIE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5861
Mailing Address - Country:US
Mailing Address - Phone:850-272-4222
Mailing Address - Fax:850-575-4503
Practice Address - Street 1:4591 BERKLIE DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5861
Practice Address - Country:US
Practice Address - Phone:850-272-4222
Practice Address - Fax:850-575-4503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty