Provider Demographics
NPI:1417644634
Name:MICHAEL ROSE PT INC
Entity type:Organization
Organization Name:MICHAEL ROSE PT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:954-621-2068
Mailing Address - Street 1:6399 NW 47TH CT # 426
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2146
Mailing Address - Country:US
Mailing Address - Phone:954-621-2068
Mailing Address - Fax:954-719-5664
Practice Address - Street 1:15455 W DIXIE HWY STE B
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-6067
Practice Address - Country:US
Practice Address - Phone:215-278-0063
Practice Address - Fax:954-719-5664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2025-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty