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General NPI Number Information
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NPI Number | 1821181348
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Entity Type | Organization
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Legal Business Name | THEODORE T LAMOTTA, INC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3900 NW 79 AVE SUITE 728
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City | DORAL
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State | FL
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Zip | 33166-6551
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Country | US
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Telephone | 305-436-1066
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Fax |
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Provider Business Mailing Address
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Address Line | 9173 SE DEERBERRY PLACE
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City | JUPITER
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State | FL
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Zip | 33469-1805
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Country | US
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Telephone | 561-392-6700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THEODORE T LAMOTTA
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Credential | M.D
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Telephone | 561-392-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME93274
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License Number State | FL
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