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General NPI Number Information
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NPI Number | 1598426512
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Entity Type | Individual
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Provider Name | MS. CARMELINA MARIA MOTT
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Gender | Female
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Dates
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Enumeration Date | 01/02/2022
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Last Update Date | 01/02/2022
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Provider Practice Location Address
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Address Line | 5091 GOLF CLUB LN
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City | SPRING HILL
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State | FL
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Zip | 34609-0314
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Country | US
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Telephone | 727-243-0625
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Fax |
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Provider Business Mailing Address
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Address Line | 5091 GOLF CLUB LN
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City | SPRING HILL
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State | FL
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Zip | 34609-0314
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Country | US
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Telephone | 727-243-0625
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11015227
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN2619352
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License Number State | FL
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