Organization Active NPI

Robert a. Rosen MD PA

  • Primary Care Clinic/Center
  • Southwest Ranches, FL
National Provider Identifier
1073902300
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
ROBERT A. ROSEN MD PA
Practice address
4929 SW 148TH Ave
Southwest Ranches, FL 33330-2400
Phone
(954) 252-5020
Fax
(954) 434-7210
NPI assigned
Jan 9, 2015
Last updated
Jan 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert Alan Rosen, MDNPI 1184688673
Title
Physician
Phone
(954) 252-5020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X ME75909 FL
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

4929 SW 148TH Ave
Southwest Ranches, FL 33330-2400

Mailing address

4929 SW 148TH Ave
Southwest Ranches, FL 33330-2400
Phone (954) 252-5020

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1079440Robert a Rosen MD PA4929 SW 148TH Ave, Davie, FL 33330Certificate of waiverJan 30, 2028

National Provider Directory

National Provider Directory

Locations

4929 SW 148th Ave
Davie, FL 33330
Phone (954) 252-5020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1073902300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4929 SW 148TH AVE",
            "city": "SOUTHWEST RANCHES",
            "state": "FL",
            "postal_code": "333302400",
            "telephone_number": "954-252-5020",
            "fax_number": "954-434-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4929 SW 148TH AVE",
            "city": "SOUTHWEST RANCHES",
            "state": "FL",
            "postal_code": "333302400",
            "telephone_number": "954-252-5020",
            "fax_number": "954-434-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A. ROSEN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "ROSEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "954-252-5020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "ME75909",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southwest Ranches, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.