MEDICARE: DR. RICHARD D. MARROTTE O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2246 OPC	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184612780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD D. MARROTTE O.D.

Provider Business Mailing Address
First Line	:	430 3RD AVE S
Second Line	:	APT 332
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33701-4189
Country	:	US
Telephone Number	:	561-702-0684
Fax Number	:

Provider Business Practice Location Address
First Line	:	2679 GULF TO BAY BLVD STE 560-570
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33759-4947
Country	:	US
Telephone Number	:	727-669-2831
Fax Number	:	727-333-7126

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2005
Last Update Date	:	03/27/2018

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