Provider Demographics
NPI:1487098059
Name:ROSEN, JASON R (DO)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:R
Last Name:ROSEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:4675 LINTON BLVD STE 203B
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-6615
Mailing Address - Country:US
Mailing Address - Phone:561-499-5341
Mailing Address - Fax:561-499-5343
Practice Address - Street 1:4675 LINTON BLVD STE 203B
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6615
Practice Address - Country:US
Practice Address - Phone:561-499-5341
Practice Address - Fax:561-499-5343
Is Sole Proprietor?:No
Enumeration Date:2013-04-25
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS14613207ZD0900X, 207ZP0101X, 207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology