Mr. Ronald Roth
Gastroenterologist
1824 Salk Ave
Tavares
, Florida 32778-4300
Mr. Ronald Roth
Gastroenterologist
1824 Salk Ave
Tavares
, Florida 32778-4300
(352) 253-1175
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About
Features
Specialties
- Gastroenterologist
Languages spoken
- English
Location
First Address
- Mr. Ronald Roth
- 1824 Salk Ave
- Tavares, FL
- Zip : 32778-4300
- Fax : (352) 253-1175
- Phone : (352) 253-0244
Second Address
- Mr. Ronald Roth
- 1824 Salk Ave
- Tavares, FL
- Zip : 32778-4300
- Fax : (352) 253-1175
- Phone : (352) 253-0244
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RG0100X | Gastroenterologist | ME34473 | FL |
National Provider Identifier
| NPI | 1013105253 |
|---|---|
| Provider Name | Mr. Ronald Roth |
| First Address | Tavares, FL 32778-4300 |
| Second Address | Tavares, FL 32778-4300 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/10/2007 |
| Last Update Date | 12/10/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 372604500 | (05) | FL |
| 93724 | BCBS (01) | FL |
| D64610 | (02) | FL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.