Provider Demographics
NPI:1528180965
Name:MARCELLE ABELL-ROSEN MD PA
Entity Type:Organization
Organization Name:MARCELLE ABELL-ROSEN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABELL-ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-790-7750
Mailing Address - Street 1:255 SE 14TH ST
Mailing Address - Street 2:STE 1B
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-1852
Mailing Address - Country:US
Mailing Address - Phone:954-967-8222
Mailing Address - Fax:
Practice Address - Street 1:255 SE 14TH ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33316-1827
Practice Address - Country:US
Practice Address - Phone:954-467-3878
Practice Address - Fax:954-467-7571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-05
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL29595OtherBCBS