Provider Demographics
NPI:1336123967
Name:ROSENBERG, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
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 1:7861 STANZA STREET
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3254
Mailing Address - Country:US
Mailing Address - Phone:561-320-2445
Mailing Address - Fax:
Practice Address - Street 1:7861 STANZA STREET
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3254
Practice Address - Country:US
Practice Address - Phone:561-702-4429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME844082085R0202X
GA0505542085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000920785EMedicaid
GA000920785FMedicaid
GAP00249004OtherRAILROAD MEDICARE
GAP00249004OtherRAILROAD MEDICARE
GA000920785EMedicaid