Individual
DR. ROMMEL ORTIZ BOTE'
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7000
Mailing address
3801 SPRING ST, RACINE, WI 53405-1667
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
40935
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32552300
—
WI
01
—
40935
MD LICENSE
WI
Enumeration date
10/28/2005
Last updated
12/28/2021
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