Active NPI
Alan Lawrence Rose, M.D
- Nephrology Physician
- Hollywood, FL
National Provider Identifier
1104930585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 26780
- Practice address
- 4401 Hollywood Blvd
Hollywood, FL 33021 - Phone
- (954) 962-2211
- NPI assigned
- Aug 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 26780 | FL | Primary |
Addresses
Primary practice location
4401 Hollywood Blvd
Hollywood, FL 33021
Mailing address
3242 Laureloak Lane
Hollywood, FL 33021
Phone (954) 981-3318
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160411002142 | FL | Order and Referring Only - Nephrology | 5193812014 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 097643 | NY | MD | Social Worker |
| 26780 | FL | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104930585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3242 LAURELOAK LANE",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "33021",
"telephone_number": "954-981-3318"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4401 HOLLYWOOD BLVD",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "33021",
"telephone_number": "954-962-2211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "ALAN",
"middle_name": "LAWRENCE",
"name_prefix": "Dr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "FL",
"license": "26780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.