Provider Demographics
NPI:1184878381
Name:ROSENBARGER, CHRISTOPHER MAURICE (PA-C)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:MAURICE
Last Name:ROSENBARGER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3619 NE 207TH ST
Mailing Address - Street 2:APT. 2310
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-4705
Mailing Address - Country:US
Mailing Address - Phone:786-390-2191
Mailing Address - Fax:
Practice Address - Street 1:3619 NE 207TH ST
Practice Address - Street 2:APT. 2310
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-4705
Practice Address - Country:US
Practice Address - Phone:786-390-2191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104541363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant