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Individual
JAY ROSENFELD
Active
Individual
JAY ROSENFELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OP1691
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
086557500
—
FL
01
—
592932410
TAX ID
FL
01
—
OC208
STATE PHARMACOLOGY NUMBER
FL
01
—
OP1691
STATE LICENSE NUMBER
FL
Enumeration date
07/07/2005
Last updated
07/03/2010
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