Individual
DR. TRACEY ROTH
Active
Individual
DR. TRACEY ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
17157
SD
207RI0011X
Interventional Cardiology Physician
ME58465
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
056497400
—
FL
01
—
14867A
BCBS
FL
01
—
14867W
MEDICARE
—
Enumeration date
08/26/2005
Last updated
04/13/2026
Update your record
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