| Amy Rosenthal Pa | |
|
743 N Northlake Dr Hollywood FL 33019-1110 | |
| (954) 789-2425 | |
| Not Available |
| Full Name | Amy Rosenthal Pa |
|---|---|
| Speciality | Social Worker |
| Location | 743 N Northlake Dr, Hollywood, Florida |
| Authorized Official Name and Position | Amy Rosenthal (PRESIDENT) |
| Authorized Official Contact | 9547892425 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Rosenthal Pa 743 N Northlake Dr Hollywood FL 33019-1110 Ph: (954) 789-2425 | Amy Rosenthal Pa 743 N Northlake Dr Hollywood FL 33019-1110 Ph: (954) 789-2425 |
| NPI Number | 1134828056 |
|---|---|
| Provider Enumeration Date | 02/28/2023 |
| Last Update Date | 02/28/2023 |
| Certification Date | 02/28/2023 |
| Medicare PECOS PAC ID | 8820454812 |
|---|---|
| Medicare Enrollment ID | O20230522001582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134828056 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Amy Rosenthal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891930814 PECOS PAC ID: 2961437280 Enrollment ID: I20230522001956 |
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