1205017134 NPI number — HARRY M ROSENBLUM MDPA

Table of content: (NPI 1205017134)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205017134 NPI number — HARRY M ROSENBLUM MDPA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARRY M ROSENBLUM MDPA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
TALLAHASSEE HEART SURGERY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205017134
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/01/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1896A BUFORD BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TALLAHASSEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32308-4442
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-877-0444
Provider Business Mailing Address Fax Number:
850-656-6820

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1896A BUFORD BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TALLAHASSEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32308-4442
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-877-0444
Provider Business Practice Location Address Fax Number:
850-656-6820
Provider Enumeration Date:
11/20/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ROSENBLUM
Authorized Official First Name:
HARRY
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
PRESIDENT OF CORP.
Authorized Official Telephone Number:
850-877-0444

Provider Taxonomy Codes

  • Taxonomy code: 208G00000X , with the licence number:  ME0047785 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com