Basic Information
| Provider Information | |||||||||
| NPI: | 1861439622 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROSENZWEIG | ||||||||
| FirstName: | HOWARD | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2511 REGAL RIVER RD | ||||||||
| Address2: | |||||||||
| City: | VALRICO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335968307 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8136439542 | ||||||||
| FaxNumber: | 8136511595 | ||||||||
| Practice Location | |||||||||
| Address1: | 325 AVENUE B NW | ||||||||
| Address2: | |||||||||
| City: | WINTER HAVEN | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33881 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8632914000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2006 | ||||||||
| LastUpdateDate: | 03/03/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | ME0067498 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 26413 | 01 | FL | BCBS | OTHER | 376883000 | 05 | FL | MEDICAID | 050088019 | 01 | FL | RAILROAD MEDICARE | OTHER |