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Individual
DR. ROGER A OTTO
Active
Individual
DR. ROGER A OTTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1436
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4354230001
DMEC MEDICARE
FL
Enumeration date
05/09/2006
Last updated
12/11/2008
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