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General NPI Number Information
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NPI Number | 1841285376
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Entity Type | Individual
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Provider Name | ROBERT E BOTTI JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/12/2005
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Last Update Date | 10/26/2012
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Provider Practice Location Address
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Address Line | 7200 MENTOR AVE
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City | MENTOR
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State | OH
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Zip | 44060-7522
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Country | US
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Telephone | 440-942-5400
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Fax | 440-942-9055
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Provider Business Mailing Address
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Address Line | 7200 MENTOR AVE
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City | MENTOR
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State | OH
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Zip | 44060-7522
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Country | US
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Telephone | 440-942-5400
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Fax | 440-942-9055
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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 | 35052571B
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License Number State | OH
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