Provider Demographics
NPI:1205357373
Name:MICHAEL S. ROSENBAUM, PH.D., P.C.
Entity Type:Organization
Organization Name:MICHAEL S. ROSENBAUM, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:R
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:251-344-1482
Mailing Address - Street 1:13610 CAMBRIA BAY LN
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-5660
Mailing Address - Country:US
Mailing Address - Phone:251-554-4927
Mailing Address - Fax:561-359-2836
Practice Address - Street 1:13610 CAMBRIA BAY LN
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-5660
Practice Address - Country:US
Practice Address - Phone:251-554-4927
Practice Address - Fax:561-359-2836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL330251S00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health