MEDICARE: DR. JILL MARIE ROEHR 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
1	208600000X	Surgery Physician	ME83272	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0046994	OTHER	FL	CIGNA
2	2275420	OTHER	FL	UNITED
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	5740708	OTHER	FL	AETNA
5	62735	OTHER	FL	BCBS
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104894567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JILL MARIE ROEHR M.D.

Provider Business Mailing Address
First Line	:	3131 N MCMULLEN BOOTH RD
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33761-2008
Country	:	US
Telephone Number	:	727-726-8871
Fax Number	:	727-726-6822

Provider Business Practice Location Address
First Line	:	1258 W BAY DR
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33770-2242
Country	:	US
Telephone Number	:	727-586-3751
Fax Number	:	727-587-9340

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

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	07/26/2024

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