Provider Demographics
NPI:1811924236
Name:ROTHENBERG, SUSANNAH (MD)
Entity type:Individual
Prefix:DR
First Name:SUSANNAH
Middle Name:
Last Name:ROTHENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5503 S CONGRESS AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ATLANTIS
Mailing Address - State:FL
Mailing Address - Zip Code:33462-6625
Mailing Address - Country:US
Mailing Address - Phone:561-434-0353
Mailing Address - Fax:
Practice Address - Street 1:5503 S CONGRESS AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:ATLANTIS
Practice Address - State:FL
Practice Address - Zip Code:33462-6625
Practice Address - Country:US
Practice Address - Phone:561-434-0353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72140207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine