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NPI Code Detail

MEDICARE: DR. ALEXANDRE T ROTTA M.D.

MEDICARE: DR. ALEXANDRE T ROTTA M.D.
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
12080P0203XPediatric Critical Care Medicine Physician01065864IN
2207LC0200XCritical Care Medicine (Anesthesiology) Physician01065864IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023079316
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEXANDRE T ROTTA M.D.
Provider Business Mailing Address
First Line : 24701 EUCLID AVE
Second Line : 3RD FLOOR
City : EUCLID
State : OH
Zip : 44117-1714
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11100 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1716
Country : US
Telephone Number : 216-844-7700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 03/07/2013

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