Provider Demographics
NPI:1982797999
Name:ROSENBERG, STANLEY (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:
Last Name:ROSENBERG
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 1:8940 N KENDALL DRIVE
Mailing Address - Street 2:STE 703E
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2175
Mailing Address - Country:US
Mailing Address - Phone:305-279-3400
Mailing Address - Fax:305-279-3988
Practice Address - Street 1:8940 N KENDALL DRIVE
Practice Address - Street 2:STE 703E
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2175
Practice Address - Country:US
Practice Address - Phone:305-279-3400
Practice Address - Fax:305-279-3988
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0023219207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL78280OtherBCBS
D65822Medicare UPIN
FL78280AMedicare ID - Type Unspecified
FL1131430001Medicare NSC