| Donald L Rose Psyd And Associates Pa | |
|
5501 Bayview Drive Fort Lauderdale FL 33308 | |
| (954) 941-4388 | |
| (954) 941-4389 |
| Full Name | Donald L Rose Psyd And Associates Pa |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 5501 Bayview Drive, Fort Lauderdale, Florida |
| Authorized Official Name and Position | Donald L Rose (OWNER) |
| Authorized Official Contact | 9549414388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Donald L Rose Psyd And Associates Pa 6278 N Federal Hwy Ste 29 Fort Lauderdale FL 33308-1916 Ph: (954) 941-4388 | Donald L Rose Psyd And Associates Pa 5501 Bayview Drive Fort Lauderdale FL 33308 Ph: (954) 941-4388 |
| NPI Number | 1891742987 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 09/24/2024 |
| Certification Date | 09/03/2024 |
| Medicare PECOS PAC ID | 5496767485 |
|---|---|
| Medicare Enrollment ID | O20100713000519 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891742987 | NPI | - | NPPES |
| 1063461127 | Other | FL | INDIVIDUAL NPI |
| K9846 | Other | FL | GROUP |
| PY0003878 | Other | FL | STATE LICENSE |
| 1891742987 | Other | FL | GROUP NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PY0003878 (Florida) | Primary |
| Provider Name | Donald L Rose |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063461127 PECOS PAC ID: 8820009038 Enrollment ID: I20060531000116 |
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