Provider Demographics
NPI:1598751745
Name:ROHART, PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:ROHART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 CARLYLE CIR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-1804
Mailing Address - Country:US
Mailing Address - Phone:727-424-9787
Mailing Address - Fax:
Practice Address - Street 1:6401 N FEDERAL HWY
Practice Address - Street 2:IMPERIAL POINT ED
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1405
Practice Address - Country:US
Practice Address - Phone:954-776-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59841207P00000X
HI7264207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E47157Medicare UPIN