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General NPI Number Information
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NPI Number | 1922036458
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Entity Type | Individual
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Provider Name | DAVID M ROTH OD
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 04/21/2022
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Provider Practice Location Address
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Address Line | 136 NE 2ND AVE
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City | MIAMI
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State | FL
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Zip | 33132-2509
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Country | US
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Telephone | 305-374-5127
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Fax | 305-374-2123
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Provider Business Mailing Address
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Address Line | 136 NE 2ND AVE
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City | MIAMI
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State | FL
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Zip | 33132-2509
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Country | US
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Telephone | 305-984-8476
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Fax | 305-532-7684
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OPC2436
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 2436
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2436
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License Number State | FL
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