MEDICARE: JEFFREY ROTHMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	OT10916	FL

General Provider Information

NPI Number	:	1013099654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY ROTHMAN

Provider Business Mailing Address
First Line	:	110 FOXFORD CT
Second Line	:
City	:	JUPITER
State	:	FL
Zip	:	33458-6508
Country	:	US
Telephone Number	:	561-676-8183
Fax Number	:

Provider Business Practice Location Address
First Line	:	2505 METROCENTRE BLVD
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3114
Country	:	US
Telephone Number	:	561-676-8183
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	07/08/2007

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