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Individual

DR. LESLIE B. ROSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
895 SW 30TH AVE, SUITE 101, POMPANO BEACH, FL 33069-4887
(954) 633-3387
(954) 633-3217
Mailing address
14275 MIDWAY RD, SUITE 400, ADDISON, TX 75001-3614
(954) 633-3387
(610) 271-4245

Taxonomy

Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
ME36847
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
ME36847
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
068525901
FL
01
96209
BCBS FL
FL
Enumeration date
12/09/2005
Last updated
05/29/2015
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