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General NPI Number Information
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NPI Number | 1831396472
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Entity Type | Individual
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Provider Name | ROLANDO TOMAS OTERO M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 13770 PLANTATION RD STE 1
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City | FORT MYERS
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State | FL
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Zip | 33912-4460
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Country | US
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Telephone | 239-689-5561
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Fax | 239-689-5958
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Provider Business Mailing Address
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Address Line | 13770 PLANTATION RD STE 1
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City | FORT MYERS
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State | FL
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Zip | 33912-4460
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Country | US
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Telephone | 239-689-5561
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Fax | 239-689-5958
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME0102039
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License Number State | FL
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