Provider Demographics
NPI:1174900138
Name:ROSENSON, ROBERT
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:ROSENSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 565473
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33256-5473
Mailing Address - Country:US
Mailing Address - Phone:305-562-2873
Mailing Address - Fax:
Practice Address - Street 1:680 NE 64TH ST
Practice Address - Street 2:APT A411
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-6208
Practice Address - Country:US
Practice Address - Phone:305-562-2873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health