Provider Demographics
NPI:1750307823
Name:ROSENBAUM, SHARI B (MD)
Entity type:Individual
Prefix:DR
First Name:SHARI
Middle Name:B
Last Name:ROSENBAUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1500 NW 10TH AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1344
Mailing Address - Country:US
Mailing Address - Phone:561-717-7057
Mailing Address - Fax:561-717-7110
Practice Address - Street 1:1500 NW 10TH AVE STE 105
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1344
Practice Address - Country:US
Practice Address - Phone:561-717-7057
Practice Address - Fax:561-717-7110
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME95253207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H80461Medicare UPIN
NY8P1082Medicare ID - Type Unspecified