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Individual

DIANE N ROSENTHAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
125 BAPTIST WAY STE 4A, PENSACOLA, FL 32503-2274
(448) 227-6480
Mailing address
PO BOX 95590, SOUTH JORDAN, UT 84095-0590
(801) 352-9500

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9118724
FL
363AM0700X
Medical Physician Assistant
363AS0400X
Surgical Physician Assistant
Primary
25MP00122500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
25MP00122500
STATE OF NJ LICENSE
NJ
Enumeration date
02/06/2007
Last updated
02/11/2026
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