Provider Demographics
NPI:1275597189
Name:ABELL-ROSEN, MARCELLE L (MD)
Entity Type:Individual
Prefix:
First Name:MARCELLE
Middle Name:L
Last Name:ABELL-ROSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARCELLE
Other - Middle Name:L
Other - Last Name:ABELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1330 SE 4TH AVE STE H
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1958
Mailing Address - Country:US
Mailing Address - Phone:954-467-8222
Mailing Address - Fax:954-467-1138
Practice Address - Street 1:1330 SE 4TH AVE STE H
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1958
Practice Address - Country:US
Practice Address - Phone:954-489-9994
Practice Address - Fax:954-489-9339
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93681207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I40890Medicare UPIN