Individual
KIM ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3285 CYPRESS LEGENDS CIR APT 934, FORT MYERS, FL 33905-5537
(301) 787-7783
Mailing address
3285 CYPRESS LEGENDS CIR APT 934, FORT MYERS, FL 33905-5537
(301) 787-7783
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9365090
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163W00000X
163W00000X
FL
Enumeration date
04/08/2015
Last updated
04/08/2015
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