Provider Demographics
NPI:1801964176
Name:ROSEN, LAUREN ESTHER (PT, MPT, ATP)
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:ESTHER
Last Name:ROSEN
Suffix:
Gender:F
Credentials:PT, MPT, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S HARBOUR ISLAND BLVD
Mailing Address - Street 2:UNIT 541
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5712
Mailing Address - Country:US
Mailing Address - Phone:813-600-4404
Mailing Address - Fax:813-554-8189
Practice Address - Street 1:3001 W DR MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6307
Practice Address - Country:US
Practice Address - Phone:813-870-4242
Practice Address - Fax:813-554-8189
Is Sole Proprietor?:No
Enumeration Date:2006-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT15231225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist