Elliott B Rosenbaum, PSYD PA

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

4465 Baymeadows Rd
Jacksonville, FL 32217-4732

Phone

(904) 252-7979

NPI assigned

Feb 2, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306368000000",
    "number": "1336387166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3113 CORNELIA DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322575817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 BAYMEADOWS RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174732",
            "telephone_number": "904-252-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBAUM",
        "first_name": "ELLIOTT",
        "middle_name": "B",
        "credential": "PSYD PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-02",
        "last_updated": "2011-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert E Rosemund, MD
• Doris Emily Rosen, DO
• Kayleigh Carol Rosen
• Shelley Joy Rosen, LMFT
• Madelyn Grace Rosenau
• Carli Anne Rosenberg I
• Christopher David Rosenberg, RN
• Jamie Phyllis Tate Rosenberg, RBT
• Lee D Rosenberg, MD
• Leslie Dawn Rosenberg, APRN

• Psychologist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.