Provider Demographics
NPI:1023338878
Name:ROLLE, CHARLOTTE-PAIGE MELANIE (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLOTTE-PAIGE
Middle Name:MELANIE
Last Name:ROLLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-1851
Mailing Address - Country:US
Mailing Address - Phone:407-647-3960
Mailing Address - Fax:407-413-5775
Practice Address - Street 1:1707 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1851
Practice Address - Country:US
Practice Address - Phone:407-647-3960
Practice Address - Fax:407-367-0856
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME132357207RI0200X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021267100Medicaid