Provider Demographics
NPI:1245225630
Name:ROSENBERG, STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:ROSENBERG
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 1:1890 STATE ROAD 436
Mailing Address - Street 2:SUITE 215
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2285
Mailing Address - Country:US
Mailing Address - Phone:407-678-4040
Mailing Address - Fax:407-678-6935
Practice Address - Street 1:1890 STATE ROAD 436
Practice Address - Street 2:SUITE 215
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2285
Practice Address - Country:US
Practice Address - Phone:407-678-4040
Practice Address - Fax:407-678-6935
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME036327207RA0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001565800Medicaid
FL47344OtherBCBS
FL1245225630Medicare Oscar/Certification
FL001565800Medicaid