Provider Demographics
NPI:1134148455
Name:ROSENTHAL, ANDREW H (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:H
Last Name:ROSENTHAL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9868 NORTH STATE ROAD 7
Mailing Address - Street 2:SUITE 330
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472
Mailing Address - Country:US
Mailing Address - Phone:561-880-8866
Mailing Address - Fax:
Practice Address - Street 1:9868 NORTH STATE ROAD 7
Practice Address - Street 2:STE 330
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472
Practice Address - Country:US
Practice Address - Phone:561-880-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD25993208200000X
FLME89367208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
38257OtherBCBS GROUP NUMBER
0007468622OtherAETNA PROVIDER #
37842OtherBCBS PROVIDER #
FL37842Medicare ID - Type Unspecified
FLI08256Medicare UPIN