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General NPI Number Information
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NPI Number | 1679673057
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Entity Type | Individual
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Provider Name | JACQUES J LAMOTHE MD
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 1900 NEBRASKA AVE STE 9
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City | FORT PIERCE
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State | FL
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Zip | 34950-4837
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Country | US
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Telephone | 772-465-4499
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Fax | 772-466-0832
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Provider Business Mailing Address
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Address Line | 4285 SE FRAZIER CT
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City | STUART
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State | FL
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Zip | 34997-5679
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Country | US
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Telephone | 702-523-7599
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 20494
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 7158
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME140644
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME140644
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License Number State | FL
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