Provider Demographics
NPI:1689822413
Name:ROSEN, ALEXANDRE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRE
Middle Name:
Last Name:ROSEN
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 1:6101 PINE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-3900
Mailing Address - Country:US
Mailing Address - Phone:239-348-4221
Mailing Address - Fax:239-348-4307
Practice Address - Street 1:6101 PINE RIDGE RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119
Practice Address - Country:US
Practice Address - Phone:239-348-4221
Practice Address - Fax:239-348-4307
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125052815208800000X
FLME114730208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP1010209OtherFREEDOM HEALTH
FL14R86OtherBCBS OF FL
FL996164OtherWELLCARE
FL4846183OtherCIGNA
FLP01562261OtherRR MEDICARE
FLP01807113OtherCLEAR HEALTH ALLIANCE
FL009559100Medicaid
FLP01215966OtherRAILROAD MCR
FL367693OtherAVMED
FL4128145OtherAETNA
FLP01215966OtherRAILROAD MCR