Provider Demographics
NPI:1790021731
Name:ROSENTHAL, OREN (PT)
Entity Type:Individual
Prefix:DR
First Name:OREN
Middle Name:
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7628 DOUBLE PINE DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-1430
Mailing Address - Country:US
Mailing Address - Phone:941-343-0188
Mailing Address - Fax:
Practice Address - Street 1:7628 DOUBLE PINE DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-1430
Practice Address - Country:US
Practice Address - Phone:941-343-0188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT16908225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist