Provider Demographics
NPI:1205017134
Name:HARRY M ROSENBLUM MDPA
Entity Type:Organization
Organization Name:HARRY M ROSENBLUM MDPA
Other - Org Name:TALLAHASSEE HEART SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OF CORP.
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROSENBLUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PA
Authorized Official - Phone:850-877-0444
Mailing Address - Street 1:1896A BUFORD BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4442
Mailing Address - Country:US
Mailing Address - Phone:850-877-0444
Mailing Address - Fax:850-656-6820
Practice Address - Street 1:1896A BUFORD BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4442
Practice Address - Country:US
Practice Address - Phone:850-877-0444
Practice Address - Fax:850-656-6820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-20
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0047785208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
K0888Medicare PIN