Provider Demographics
NPI:1962487058
Name:ROSENBLUM, PAUL DAVID (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:DAVID
Last Name:ROSENBLUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:PAUL
Other - Middle Name:D
Other - Last Name:ROSENBLUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:840 US HIGHWAY 1
Mailing Address - Street 2:SUITE 430
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3830
Mailing Address - Country:US
Mailing Address - Phone:561-627-6333
Mailing Address - Fax:561-627-3907
Practice Address - Street 1:840 US HIGHWAY 1
Practice Address - Street 2:SUITE 430
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3830
Practice Address - Country:US
Practice Address - Phone:561-627-6333
Practice Address - Fax:561-627-3907
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0033686207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD58784Medicare UPIN
FL79430Medicare PIN