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Organization
SUNCOAST PATHOLOGY
Active
Organization
SUNCOAST PATHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM G ROTH M.D. (VICE PRESIDENT/SECRETARY)
(941) 483-3319
Entity
Organization
Contact information
Practice address
446 TAMIAMI TRL S, SECOND FLOOR, VENICE, FL 34285-2625
(941) 483-3319
(941) 483-3406
Mailing address
446 TAMIAMI TRL S, SECOND FLOOR, VENICE, FL 34285-2625
(941) 483-3319
(941) 483-3406
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
800000658
FL
207ZD0900X
Dermatopathology (Pathology) Physician
800000658
FL
207ZI0100X
Immunopathology Physician
800000658
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
800000658
FL
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
800000658
FL
Other
Enumeration date
05/27/2006
Last updated
08/18/2011
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