Provider Demographics
NPI:1942242789
Name:ROSENTHAL, MARC I (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:I
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1465 CARDINAL WAY
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-2003
Mailing Address - Country:US
Mailing Address - Phone:954-385-7281
Mailing Address - Fax:
Practice Address - Street 1:1835 S PERIMETER RD
Practice Address - Street 2:SUITE 140
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-7121
Practice Address - Country:US
Practice Address - Phone:800-558-7281
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS30393183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist