Provider Demographics
NPI:1568788776
Name:ROTHENBERGER, JOSEPHINE (RPH)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:
Last Name:ROTHENBERGER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 S CONGRESS AVE
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-2140
Mailing Address - Country:US
Mailing Address - Phone:561-966-5114
Mailing Address - Fax:561-965-8419
Practice Address - Street 1:1700 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2140
Practice Address - Country:US
Practice Address - Phone:561-966-5114
Practice Address - Fax:561-965-8419
Is Sole Proprietor?:No
Enumeration Date:2010-04-13
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049726183500000X
FLPS45973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist