Healthcare Provider Details

I. General information

NPI: 1912351727
Provider Name (Legal Business Name): SUNIL ROHATGI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2016
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 N LECANTO HWY
LECANTO FL
34461-9187
US

IV. Provider business mailing address

PO BOX 102222
ATLANTA GA
30368-2222
US

V. Phone/Fax

Practice location:
  • Phone: 352-746-0707
  • Fax:
Mailing address:
  • Phone: 239-432-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME155567
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: