Provider Demographics
NPI:1760591853
Name:ROOFEH, ROSA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:
Last Name:ROOFEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9960 CENTRAL PARK BLVD N
Mailing Address - Street 2:SUITE 450
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-1759
Mailing Address - Country:US
Mailing Address - Phone:561-353-1225
Mailing Address - Fax:561-353-1226
Practice Address - Street 1:3345 BURNS RD STE 302
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4321
Practice Address - Country:US
Practice Address - Phone:561-622-7661
Practice Address - Fax:561-622-4651
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80712207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG39153Medicare UPIN