Provider Demographics
NPI:1972646362
Name:ALLAN W. ROTHSCHILD, D.P.M., P.A.
Entity Type:Organization
Organization Name:ALLAN W. ROTHSCHILD, D.P.M., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:ROTHSCHILD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:727-734-5575
Mailing Address - Street 1:1022 MAIN ST
Mailing Address - Street 2:SUITE L
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-5238
Mailing Address - Country:US
Mailing Address - Phone:727-734-5575
Mailing Address - Fax:
Practice Address - Street 1:1022 MAIN ST
Practice Address - Street 2:SUITE L
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-5238
Practice Address - Country:US
Practice Address - Phone:727-734-5575
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 472332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL480486064OtherRAILROAD MEDICARE
FL087542001OtherPALMETTO DMERC PROVIDER #
FL87217OtherMEDICARE PTAN
FL041100100Medicaid
FL87217OtherMEDICARE PTAN