Provider Demographics
NPI:1023288354
Name:ERIC D. ROSENKRANTZ M.D. PA
Entity type:Organization
Organization Name:ERIC D. ROSENKRANTZ M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROSENKRANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-540-4500
Mailing Address - Street 1:643 CAPE CORAL PKWY E
Mailing Address - Street 2:SUITE F
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33904-8549
Mailing Address - Country:US
Mailing Address - Phone:239-540-4500
Mailing Address - Fax:239-540-1952
Practice Address - Street 1:643 CAPE CORAL PKWY E
Practice Address - Street 2:SUITE F
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-8549
Practice Address - Country:US
Practice Address - Phone:239-540-4500
Practice Address - Fax:239-540-1952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME45339207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME45339OtherLICENSE NUMBER
FLME45339OtherLICENSE NUMBER