Provider Demographics
NPI:1366863011
Name:PARAGON OB GYN PA
Entity Type:Organization
Organization Name:PARAGON OB GYN PA
Other - Org Name:ERIC ROTHSCHILD, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHSCHILD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-256-8200
Mailing Address - Street 1:2301 N UNIVERSITY DR STE 212
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3617
Mailing Address - Country:US
Mailing Address - Phone:954-256-8200
Mailing Address - Fax:954-256-8170
Practice Address - Street 1:2301 N UNIVERSITY DR
Practice Address - Street 2:SUITE 212
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3617
Practice Address - Country:US
Practice Address - Phone:954-256-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-25
Last Update Date:2014-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94485207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010356400Medicaid
FL010356400Medicaid