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NPI Code Detail

MEDICARE: THE MOTTAS COMPANY

MEDICARE: THE MOTTAS COMPANY
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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1699112672
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE MOTTAS COMPANY
Provider Business Mailing Address
First Line : 2951 MERRILL BLVD
Second Line :
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-3187
Country : US
Telephone Number : 904-485-0444
Fax Number : 904-296-5045
Provider Business Practice Location Address
First Line : 2 FAIRFIELD BLVD
Second Line : SUITE 4
City : PONTE VEDRA BEACH
State : FL
Zip : 32082-4626
Country : US
Telephone Number : 904-485-0444
Fax Number : 904-296-5045
Authorized Official
Title or Position : CEO/PRESIDENT
Name : MR. CHRISTIAN THOMAS MOTTAS
Credential :
Telephone Number : 904-485-0444
Provider Enumeration Date : 05/30/2013
Last Update Date : 05/30/2013

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Directions to “THE MOTTAS COMPANY ” Practice Location

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