MEDICARE: DR. A JOSEPH MOTTA M.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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	ME0031601	FL

General Provider Information

NPI Number	:	1518968007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. A JOSEPH MOTTA M.D.

Provider Business Mailing Address
First Line	:	3370 BURNS RD
Second Line	:	SUITE 206
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4327
Country	:	US
Telephone Number	:	561-626-9801
Fax Number	:	561-626-9804

Provider Business Practice Location Address
First Line	:	3370 BURNS RD
Second Line	:	SUITE 206
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4327
Country	:	US
Telephone Number	:	561-626-9801
Fax Number	:	561-626-9804

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/08/2007

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