Provider Demographics
NPI:1437225521
Name:ROSE MAY SEIDE, MD PA
Entity Type:Organization
Organization Name:ROSE MAY SEIDE, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSE MY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PA
Authorized Official - Phone:786-402-0351
Mailing Address - Street 1:2236 SW 166TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4445
Mailing Address - Country:US
Mailing Address - Phone:786-402-0351
Mailing Address - Fax:
Practice Address - Street 1:2236 SW 166TH AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4445
Practice Address - Country:US
Practice Address - Phone:786-402-0351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81771207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLW12905Medicare UPIN