Provider Demographics
NPI:1912075003
Name:D. SCOTT ROTATORI, M.D., P.A.
Entity Type:Organization
Organization Name:D. SCOTT ROTATORI, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-628-5476
Mailing Address - Street 1:800 W MORSE BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-3797
Mailing Address - Country:US
Mailing Address - Phone:407-628-5476
Mailing Address - Fax:407-628-4108
Practice Address - Street 1:800 W MORSE BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-3797
Practice Address - Country:US
Practice Address - Phone:407-628-5476
Practice Address - Fax:407-628-4108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0051444174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherFEDERAL TAX ID
FLF56818Medicare UPIN
FLK9233Medicare ID - Type UnspecifiedMEDICARE ID