Provider Demographics
NPI:1942203237
Name:ROSABAL, ORESTES G (MD)
Entity Type:Individual
Prefix:
First Name:ORESTES
Middle Name:G
Last Name:ROSABAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7100 W 20TH AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-1897
Mailing Address - Country:US
Mailing Address - Phone:305-822-0401
Mailing Address - Fax:305-824-1748
Practice Address - Street 1:7100 W 20TH AVE
Practice Address - Street 2:STE 101
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-1897
Practice Address - Country:US
Practice Address - Phone:305-822-0401
Practice Address - Fax:305-824-1748
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
FLME0038252207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL026533OtherNEIGHBORHOOD HEALTH
FL205083OtherAVMED
FL2332362OtherAETNA HMO
FL2000978OtherAETNA PPO
FL95741OtherBCBS
FL0724570004OtherCIGNA
FLD63590Medicare UPIN
FL026533OtherNEIGHBORHOOD HEALTH