Elliott B Rosenbaum PSYD PA

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

PY8117 Issued in FL

Legal business name

ELLIOTT B ROSENBAUM PSYD PA

Practice address

4465 Baymeadows Rd
Suite 7
Jacksonville, FL 32217-4732

Phone

(904) 252-7979

NPI assigned

Jun 16, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Elliott Rosenbaum, PSYD

Title

Director

Phone

(904) 252-7979

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308182400000",
    "number": "1912292004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4465 BAYMEADOWS RD",
            "address_2": "SUITE 7",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4465 BAYMEADOWS RD",
            "address_2": "SUITE 7",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174732",
            "telephone_number": "904-252-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIOTT B ROSENBAUM PSYD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-16",
        "last_updated": "2011-06-16",
        "status": "A",
        "authorized_official_last_name": "ROSENBAUM",
        "authorized_official_first_name": "ELLIOTT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-252-7979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "PY8117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Eller
• Nicole Eller
• David Lofton Ellerbe, P.A.
• Enrique Elli, MD
• Melissa Elliot
• Amanda Elliott, APRN
• Angela Marie Elliott, CNM
• Billy Merrill Elliott III
• Carolyn Rose Elliott, PT, DPT
• Chiquita Elliott

• Community/Behavioral Health Agency in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.