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NPI Code Detail

MEDICARE: MRS. DEBRA K. MOTTOLA RPH

MEDICARE: MRS. DEBRA K. MOTTOLA RPH
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
1183500000XPharmacistPS21406FL

General Provider Information

NPI Number : 1790069680
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBRA K. MOTTOLA RPH
Provider Business Mailing Address
First Line : 16200 COUNTY LINE RD
Second Line :
City : SPRING HILL
State : FL
Zip : 34610-1351
Country : US
Telephone Number : 727-379-9808
Fax Number :
Provider Business Practice Location Address
First Line : 16200 COUNTY LINE RD
Second Line :
City : SPRING HILL
State : FL
Zip : 34610-1351
Country : US
Telephone Number : 727-379-9808
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2011
Last Update Date : 10/10/2011

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