Provider Demographics
NPI:1811596562
Name:SHARI ROSENBAUM MD PLLC
Entity Type:Organization
Organization Name:SHARI ROSENBAUM MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHARI
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROSENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-504-0338
Mailing Address - Street 1:1905 CLINT MOORE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2660
Mailing Address - Country:US
Mailing Address - Phone:561-994-8595
Mailing Address - Fax:561-988-0445
Practice Address - Street 1:1905 CLINT MOORE RD STE 204
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2660
Practice Address - Country:US
Practice Address - Phone:561-994-8595
Practice Address - Fax:561-988-0445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-23
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty