Basic Information
Provider Information
NPI: 1700431954
EntityType: 2
ReplacementNPI:  
OrganizationName: ROSIN EYECARE, P.A.
LastName:  
FirstName:  
MiddleName:  
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NameSuffix:  
Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 6233 CERMAK RD
Address2:  
City: BERWYN
State: IL
PostalCode: 604022317
CountryCode: US
TelephoneNumber: 7087492020
FaxNumber:  
Practice Location
Address1: 17941 BISCAYNE BLVD
Address2:  
City: AVENTURA
State: FL
PostalCode: 331602502
CountryCode: US
TelephoneNumber: 3059310225
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/05/2019
LastUpdateDate: 08/05/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: CHIARAMONTI
AuthorizedOfficialFirstName: NICHOLAS
AuthorizedOfficialMiddleName: A
AuthorizedOfficialTitleorPosition: DIRECTOR
AuthorizedOfficialTelephone: 6305468319
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix: JR.
AuthorizedOfficialCredential: OD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X  Y193400000X SINGLE SPECIALTY GROUPEye and Vision Services ProvidersOptometrist 

No ID Information.


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