Individual
GABRIELLE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1921 WALDEMERE ST, SARASOTA, FL 34239-2943
(941) 952-4001
(941) 952-4028
Mailing address
PO BOX 947407, ATLANTA, GA 30394-7407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9116610
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9116610
MED LIC
FL
Enumeration date
10/17/2022
Last updated
02/10/2023
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