Individual
DR. JACOB ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4000 HOLLYWOOD BLVD STE 745S, HOLLYWOOD, FL 33021-1218
(585) 474-4589
Mailing address
911 WOOD ST APT 2, PHILADELPHIA, PA 19107-1886
(585) 474-4589
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC007030
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/03/2019
Last updated
03/01/2022
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