Individual
MARK S ROSENBLOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1223 GATEWAY DR, MELBOURNE, FL 32901-2607
(321) 725-4500
(321) 768-0039
Mailing address
1223 GATEWAY DR, MELBOURNE, FL 32901-2607
(321) 725-4500
(321) 768-0039
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
ME61651
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
370166200
—
FL
01
—
770001972
RR MEDICARE
FL
Enumeration date
12/07/2005
Last updated
02/02/2010
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