Healthcare Provider Details

I. General information

NPI: 1144218892
Provider Name (Legal Business Name): ROLAND ZSOLT GERENCER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 OSPREY BLVD STE 100
BARTOW FL
33830-4340
US

IV. Provider business mailing address

13216 MOONDANCE PL NE
ALBUQUERQUE NM
87111-8253
US

V. Phone/Fax

Practice location:
  • Phone: 863-904-6296
  • Fax: 866-264-8519
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME175645
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: