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General NPI Number Information
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NPI Number | 1386620615
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Entity Type | Organization
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Legal Business Name | JACK N ROTHMAN MD
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Dates
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Enumeration Date | 12/19/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 601 MAIN ST STE 601
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City | DUNEDIN
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State | FL
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Zip | 34698-5848
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Country | US
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Telephone | 727-734-6811
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Fax | 727-736-2526
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Provider Business Mailing Address
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Address Line | 601 MAIN ST STE 601
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City | DUNEDIN
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State | FL
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Zip | 34698-5848
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Country | US
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Telephone | 727-734-6811
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Fax | 727-736-2526
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Authorized Official
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Title or Position | OWNER SOLE PROPRIETORSHIP
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Name | DR. JACK N ROTHMAN
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Credential | MD FACOG
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Telephone | 727-734-6811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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