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NPI Code Detail

MEDICARE: ILENE RENEE ROTMAN M.S. CCC-SLP

MEDICARE: ILENE RENEE ROTMAN M.S. CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSA8817FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1376670984
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILENE RENEE ROTMAN M.S. CCC-SLP
Provider Business Mailing Address
First Line : 7621 VENTURA LN
Second Line :
City : PARKLAND
State : FL
Zip : 33067-2302
Country : US
Telephone Number : 954-236-4495
Fax Number :
Provider Business Practice Location Address
First Line : 9508 GRIFFIN RD
Second Line :
City : COOPER CITY
State : FL
Zip : 33328-3416
Country : US
Telephone Number : 954-689-0730
Fax Number : 877-811-2570
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 03/13/2017

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Directions to “ ILENE RENEE ROTMAN M.S. CCC-SLP” Practice Location

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