Provider Demographics
NPI:1700829470
Name:ROST, EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:
Last Name:ROST
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 1:1395 NW 167TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-5710
Mailing Address - Country:US
Mailing Address - Phone:786-535-7200
Mailing Address - Fax:786-535-7294
Practice Address - Street 1:401 OPA LOCKA BLVD
Practice Address - Street 2:
Practice Address - City:OPA LOCKA
Practice Address - State:FL
Practice Address - Zip Code:33054-3528
Practice Address - Country:US
Practice Address - Phone:786-535-7200
Practice Address - Fax:786-535-7294
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL86519208M00000X
FLME86519208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL266249300Medicaid
FLH84006Medicare UPIN
FL29184ZMedicare ID - Type Unspecified