Provider Demographics
NPI:1417253121
Name:ROSENBLAT, ELAN (MD)
Entity Type:Individual
Prefix:
First Name:ELAN
Middle Name:
Last Name:ROSENBLAT
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 1:6290 LINTON BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6409
Mailing Address - Country:US
Mailing Address - Phone:561-880-2480
Mailing Address - Fax:561-880-4466
Practice Address - Street 1:6290 LINTON BLVD STE 203
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6409
Practice Address - Country:US
Practice Address - Phone:561-880-2480
Practice Address - Fax:561-880-4466
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127965207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology