Healthcare Provider Details

I. General information

NPI: 1023565397
Provider Name (Legal Business Name): RONALD ERIC GOTS MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2016
Last Update Date: 09/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 SW PALM COVE DR
PALM CITY FL
34990-4318
US

IV. Provider business mailing address

93 SW PALM COVE DR
PALM CITY FL
34990-4318
US

V. Phone/Fax

Practice location:
  • Phone: 301-466-9858
  • Fax:
Mailing address:
  • Phone: 301-466-9858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberD0015004
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: