Provider Demographics
NPI:1740398262
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 1:1871 SE TIFFANY AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7596
Mailing Address - Country:US
Mailing Address - Phone:772-924-2283
Mailing Address - Fax:772-924-2282
Practice Address - Street 1:1871 SE TIFFANY AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7596
Practice Address - Country:US
Practice Address - Phone:772-924-2283
Practice Address - Fax:772-924-2282
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME109318207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology