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General NPI Number Information
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NPI Number | 1356832281
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Entity Type | Individual
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Provider Name | STEFFANO MOTTL MD
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Gender | Male
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Dates
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Enumeration Date | 05/26/2018
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 851042 US HIGHWAY 17
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City | YULEE
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State | FL
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Zip | 32097-2845
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Country | US
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Telephone | 904-202-6683
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Fax | 904-376-3062
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Provider Business Mailing Address
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Address Line | PO BOX 746647
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City | ATLANTA
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State | GA
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Zip | 30374-6647
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Country | US
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Telephone | 904-202-2092
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Fax | 904-376-4075
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 1908R76807
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | ME175536
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License Number State | FL
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