Healthcare Provider Details

I. General information

NPI: 1841200342
Provider Name (Legal Business Name): ALICE S RHOTON-VLASAK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALICE SUE RHOTON-VLASAK

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 03/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD BOX 100371
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 918025
ORLANDO FL
32891-8025
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-6200
  • Fax: 352-392-9724
Mailing address:
  • Phone: 352-265-6200
  • Fax: 352-265-9724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberME59311
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: