Provider Demographics
NPI:1649914128
Name:DR. ASHLEY ROTH & ASSOCIATES PA
Entity type:Organization
Organization Name:DR. ASHLEY ROTH & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-984-8476
Mailing Address - Street 1:136 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-2509
Mailing Address - Country:US
Mailing Address - Phone:305-984-8476
Mailing Address - Fax:
Practice Address - Street 1:7303 SW 88TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-7801
Practice Address - Country:US
Practice Address - Phone:786-522-2850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty