1225058357 NPI number — LOUIS ROSENFIELD M.D.

Table of content: LOUIS ROSENFIELD M.D. (NPI 1225058357)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225058357 NPI number — LOUIS ROSENFIELD M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSENFIELD
Provider First Name:
LOUIS
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1225058357
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2300 LOVELAND BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORT CHARLOTTE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33980-5716
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-629-4500
Provider Business Mailing Address Fax Number:
941-629-5049

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2300 LOVELAND BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORT CHARLOTTE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33980-5716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-629-4500
Provider Business Practice Location Address Fax Number:
941-629-5049
Provider Enumeration Date:
07/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  MMD51418MD , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: 2022-00625 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: 7695 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: MD11877 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: 0101031392 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: MD11472R , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: ME-32994 , 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)

  • Identifier: 3002729 . This is a "CIGNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: P304478 . This is a "FREEDOM HC" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 100841900 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1078583 . This is a "AETNA MCR" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 95132 . This is a "BLUE SHIELD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5212334 . This is a "AETNA - COMMERCIAL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 100841900 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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