| Bennett Rosenthal M.s.,ph.d.,m.d.,p.a. | |
|
10000 W Colonial Dr Suite 289 Ocoee FL 34761-3498 | |
| (407) 296-1940 | |
| (407) 296-1942 |
| Full Name | Bennett Rosenthal M.s.,ph.d.,m.d.,p.a. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 10000 W Colonial Dr, Ocoee, Florida |
| Authorized Official Name and Position | Bennett M Rosenthal (PROVIDER/OWNER) |
| Authorized Official Contact | 4072961940 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bennett Rosenthal M.s.,ph.d.,m.d.,p.a. Po Box 1909 Windermere FL 34786-1909 Ph: (407) 296-1940 | Bennett Rosenthal M.s.,ph.d.,m.d.,p.a. 10000 W Colonial Dr Suite 289 Ocoee FL 34761-3498 Ph: (407) 296-1940 |
| NPI Number | 1992781041 |
|---|---|
| Provider Enumeration Date | 12/21/2005 |
| Last Update Date | 05/06/2009 |
| Medicare PECOS PAC ID | 8224181524 |
|---|---|
| Medicare Enrollment ID | O20090804000649 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992781041 | NPI | - | NPPES |
| 376814700 | Medicaid | FL | |
| 26248 | Other | FL | BCBSOFFLA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Bennett Merle Rosenthal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1457337503 PECOS PAC ID: 5890846059 Enrollment ID: I20090629000233 |
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