Individual
MR. RONALD ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1824 SALK AVE, TAVARES, FL 32778-4300
(352) 253-0244
(352) 253-1175
Mailing address
1824 SALK AVE, TAVARES, FL 32778-4300
(352) 253-0244
(352) 253-1175
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME34473
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372604500
—
FL
01
—
93724
BCBS
FL
Enumeration date
10/12/2007
Last updated
10/12/2007
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