# JAY ROSENFELD OD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164730297
- **Authorized official:** DR. JAY ROSENFELD OD (PRESIDENT)
- **Authorized official phone:** (727) 799-4500

## Contact information

- **Practice address:** 2541 COUNTRYSIDE BLVD STE 1, CLEARWATER, FL 33761-3504
- **Practice address phone:** (727) 799-4500
- **Practice address fax:** (727) 724-1633
- **Mailing address:** 2541 COUNTRYSIDE BLVD STE 1, CLEARWATER, FL 33761-3504
- **Mailing address phone:** (727) 799-4500
- **Mailing address fax:** (727) 724-1633

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OPC1691 | FL | Yes |

## Other

- **Enumeration date:** 09/23/2010
- **Last updated:** 09/23/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 086557500 | — | FL |
| 01 | — | 1114924040 | INDIVIDUAL NPI FOR JAY ROSENFELD OD | FL |