Provider Demographics
NPI:1528082518
Name:ROTHMAN, HERBERT L (MD)
Entity type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:L
Last Name:ROTHMAN
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 1:4302 ALTON RD
Mailing Address - Street 2:SUITE 960A
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2891
Mailing Address - Country:US
Mailing Address - Phone:305-538-0339
Mailing Address - Fax:305-538-1218
Practice Address - Street 1:4302 ALTON RD
Practice Address - Street 2:SUITE 960
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2891
Practice Address - Country:US
Practice Address - Phone:305-538-0339
Practice Address - Fax:305-538-1218
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME184402084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME18440OtherMEDICAL LICENSE
FL92127ZOtherMEDICARE PTAN
FL92127ZOtherMEDICARE PTAN