Individual
RODERICK WILSON LOVETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
851 TRAFALGAR CT STE 200E, MAITLAND, FL 32751-7420
(407) 667-0505
Mailing address
851 TRAFALGAR CT, STE 200E, MAITLAND, FL 32751-7420
(407) 667-0444
(407) 667-4338
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
L6101
TX
207L00000X
Anesthesiology Physician
MD0000035773
TN
207L00000X
Anesthesiology Physician
Primary
ME138084
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3877041
—
TN
01
—
4042226
BCBS
TN
05
—
64066020
—
KY
01
—
P00373732
MEDICARE RAILROAD
TN
Enumeration date
09/07/2005
Last updated
01/29/2019
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