Individual
TAMZIN A ROSENWASSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 SALEM ST, LAFAYETTE, IN 47904-2164
(765) 448-8000
Mailing address
4411 BEE RIDGE ROAD, PMB 309, SARASOTA, FL 34233-5545
(941) 926-6553
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01057228A
IN
207N00000X
Dermatology Physician
ME71744
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000487140
ANTHEM PROVIDER NUMBER
IN
05
—
200830950
—
IN
01
—
9294464
PHCS PID NUMBER
IN
01
—
HQ199Z
MEDICARE PTAN
FL
Enumeration date
07/03/2006
Last updated
10/13/2020
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