MEDICARE: DR. SCOTT ROTHENBERG

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	183500000X	Pharmacist	PS42973	FL

General Provider Information

NPI Number	:	1609114263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT ROTHENBERG

Provider Business Mailing Address
First Line	:	3900 66TH ST N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33709-4912
Country	:	US
Telephone Number	:	727-343-9265
Fax Number	:	727-343-9358

Provider Business Practice Location Address
First Line	:	3900 66TH ST N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33709-4912
Country	:	US
Telephone Number	:	727-343-9265
Fax Number	:	727-343-9358

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

Provider Enumeration Date	:	01/16/2013
Last Update Date	:	01/16/2013

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Directions to “ DR. SCOTT ROTHENBERG ” Practice Location

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