Individual
WAYNE R ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO, CPED,PA
Contact information
Practice address
9921 PINES BLVD, PEMBROKE PINES, FL 33024-6174
(954) 447-7779
(954) 447-7782
Mailing address
9921 PINES BLVD, PEMBROKE PINES, FL 33024-6174
(954) 447-7779
(954) 447-7782
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
PO 00039
FL
224P00000X
Prosthetist
PO 00039
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032584800
—
FL
Enumeration date
03/19/2008
Last updated
01/27/2009
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