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General NPI Number Information
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NPI Number | 1982283560
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Entity Type | Individual
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Provider Name | SAMUEL L MOTA-MARTINEZ DO
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Gender | Male
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Dates
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Enumeration Date | 04/02/2021
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Last Update Date | 02/12/2025
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Provider Practice Location Address
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Address Line | 400 N TAMPA ST FL 15
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City | TAMPA
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State | FL
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Zip | 33602-4730
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Country | US
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Telephone | 888-803-3370
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Fax |
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Provider Business Mailing Address
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Address Line | 8140 STERNWAY RD
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City | SARASOTA
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State | FL
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Zip | 34240-3700
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Country | US
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Telephone | 509-205-1189
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | T9453
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License Number State | TX
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