Provider Demographics
NPI:1013979608
Name:ROSENBERG, ROBERT KENT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:KENT
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 BURNS RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4353
Mailing Address - Country:US
Mailing Address - Phone:561-622-4944
Mailing Address - Fax:561-627-6579
Practice Address - Street 1:3355 BURNS RD
Practice Address - Street 2:SUITE 305
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4353
Practice Address - Country:US
Practice Address - Phone:561-622-4944
Practice Address - Fax:561-627-6579
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0016430208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD55878Medicare UPIN
FL50873Medicare ID - Type Unspecified