Provider Demographics
NPI:1629033253
Name:ROSENBERG, DAVID (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:ROSENBERG
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:PO BOX 151637
Mailing Address - Street 2:PEDIATRIC PULMONARY SPECIALISTS PA
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33684-1637
Mailing Address - Country:US
Mailing Address - Phone:813-870-1995
Mailing Address - Fax:813-875-1889
Practice Address - Street 1:4714 N ARMENIA AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-2603
Practice Address - Country:US
Practice Address - Phone:813-870-1995
Practice Address - Fax:813-875-1889
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00569422080P0214X, 2080S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
No2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL204478OtherAMERIGROUP
FL01424OtherSTAYWELL
FL752467OtherFIRSTHEALTH
FL100789OtherAVMED
FL2414608OtherAETNA
FL204478OtherAMERIGROUP
F33317Medicare UPIN