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NPI Code Detail

MEDICARE: DR. ROMMEL ORTIZ BOTE' M.D.

MEDICARE: DR. ROMMEL ORTIZ BOTE' M.D.
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
1207P00000XEmergency Medicine Physician40935WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
240935OTHERWIMD LICENSE

General Provider Information

NPI Number : 1841280948
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROMMEL ORTIZ BOTE' M.D.
Provider Business Mailing Address
First Line : 3801 SPRING ST
Second Line :
City : RACINE
State : WI
Zip : 53405-1667
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10400 75TH ST
Second Line :
City : KENOSHA
State : WI
Zip : 53142-7884
Country : US
Telephone Number : 262-948-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2005
Last Update Date : 12/28/2021

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