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General NPI Number Information
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NPI Number | 1730407057
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Entity Type | Organization
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Legal Business Name | MARTIN ROTHBERG, M.D. P.A.
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Dates
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Enumeration Date | 05/11/2010
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Last Update Date | 05/11/2010
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Provider Practice Location Address
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Address Line | 6469 SUNSET DR
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City | MIAMI
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State | FL
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Zip | 33143-4676
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Country | US
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Telephone | 305-613-8853
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Fax | 305-665-2695
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Provider Business Mailing Address
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Address Line | 6469 SUNSET DR
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City | MIAMI
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State | FL
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Zip | 33143-4676
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Country | US
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Telephone | 305-613-8853
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Fax | 305-665-2695
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARTIN ROTHBERG
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Credential | M.D.
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Telephone | 305-613-8853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0014724
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License Number State | FL
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