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NPI Code Detail

MEDICARE: ROBERT T ROTH M.D.

MEDICARE:   ROBERT T ROTH  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
1208600000XSurgery PhysicianME82877FL

Other Identifiers

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

General Provider Information

NPI Number : 1508861121
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT T ROTH M.D.
Provider Business Mailing Address
First Line : 2995 DREW ST
Second Line :
City : CLEARWATER
State : FL
Zip : 33759-3012
Country : US
Telephone Number : 727-315-7496
Fax Number :
Provider Business Practice Location Address
First Line : 1840 MEASE DR
Second Line : SUITE 301
City : SAFETY HARBOR
State : FL
Zip : 34695-6602
Country : US
Telephone Number : 727-724-2880
Fax Number : 727-333-6419
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 02/05/2025

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