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General NPI Number Information
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NPI Number | 1477804045
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Entity Type | Organization
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Legal Business Name | RICHARD MARROTTE, OD,PA
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Dates
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Enumeration Date | 09/24/2012
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 430 3RD AVE APT 332
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City | ST. PETERSBURG
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State | FL
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Zip | 33701
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Country | US
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Telephone | 561-702-0684
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Fax |
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Provider Business Mailing Address
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Address Line | 430 3RD AVE S APT 332
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City | ST PETERSBURG
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State | FL
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Zip | 33701-4144
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Country | US
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Telephone | 561-702-0684
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. RICHARD MARROTTE
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Credential | O.D.
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Telephone | 561-702-0684
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC 2246
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License Number State | FL
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