Organization
DONALD L ROSE PSYD AND ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD L ROSE PSY. D. (OWNER)
(954) 941-4388
Entity
Organization
Contact information
Practice address
5501 BAYVIEW DRIVE, FORT LAUDERDALE, FL 33308
(954) 941-4388
(954) 941-4389
Mailing address
6278 N FEDERAL HWY STE 29, FORT LAUDERDALE, FL 33308-1916
(954) 941-4388
(954) 941-4389
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY0003878
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063461127
INDIVIDUAL NPI
FL
01
—
1891742987
GROUP NPI
FL
01
—
K9846
GROUP
FL
01
—
PY0003878
STATE LICENSE
FL
Enumeration date
05/27/2006
Last updated
09/24/2024
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