Provider Demographics
NPI:1457389983
Name:ROSEN, SETH DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:DAVID
Last Name:ROSEN
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 1:9555 N KENDALL DR
Mailing Address - Street 2:STE 100
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1978
Mailing Address - Country:US
Mailing Address - Phone:305-273-7319
Mailing Address - Fax:305-662-9515
Practice Address - Street 1:9555 N KENDALL DR
Practice Address - Street 2:STE 100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1978
Practice Address - Country:US
Practice Address - Phone:305-273-7319
Practice Address - Fax:305-662-9515
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME52134207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME52134OtherMEDICAL LICENSE
FL061933700Medicaid
FL09877YMedicare ID - Type Unspecified
FLE83081Medicare UPIN