Provider Demographics
NPI:1598822025
Name:ROSMAN MEDICAL CLINIC PA
Entity Type:Organization
Organization Name:ROSMAN MEDICAL CLINIC PA
Other - Org Name:SOLO PRACTITIONER OWNER
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO FAAFP
Authorized Official - Phone:305-945-1545
Mailing Address - Street 1:890 N MIAMI BEACH BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:N MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-3701
Mailing Address - Country:US
Mailing Address - Phone:305-945-1545
Mailing Address - Fax:305-949-8200
Practice Address - Street 1:890 N MIAMI BEACH BOULEVARD
Practice Address - Street 2:
Practice Address - City:N MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3701
Practice Address - Country:US
Practice Address - Phone:305-945-1545
Practice Address - Fax:305-949-8200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0000969207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL81248Medicare ID - Type Unspecified
E23657Medicare UPIN