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General NPI Number Information
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NPI Number | 1386570802
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Entity Type | Organization
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Legal Business Name | ENNOBLE HC FL LLC
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Dates
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Enumeration Date | 06/22/2026
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Last Update Date | 06/22/2026
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Provider Practice Location Address
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Address Line | 29399 US HIGHWAY 19 N STE 150
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City | CLEARWATER
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State | FL
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Zip | 33761-2126
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Country | US
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Telephone | 551-295-8223
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Fax |
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Provider Business Mailing Address
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Address Line | 2 UNIVERSITY PLZ STE 204
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City | HACKENSACK
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State | NJ
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Zip | 07601-6211
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Country | US
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Telephone | 551-295-8223
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GIL ROTER
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Credential | MD
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Telephone | 516-528-7959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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