MEDICARE: NANCY ROTROFF DDS

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	122300000X	Dentist	DN10611	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DN10611	OTHER	FL	DENTAL LICENSE

General Provider Information

NPI Number	:	1124138797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY ROTROFF DDS

Provider Business Mailing Address
First Line	:	2480 EAST COMMERCIAL BLVD
Second Line	:	SUITE 2
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308
Country	:	US
Telephone Number	:	954-928-1666
Fax Number	:	954-928-1895

Provider Business Practice Location Address
First Line	:	2480 EAST COMMERCIAL BLVD
Second Line	:	SUITE 2
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308
Country	:	US
Telephone Number	:	954-928-1666
Fax Number	:	954-928-1895

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	03/07/2023

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