MEDICARE: DR. RALPH CHRISTOPHER VOTOLATO PSY. 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	103TC0700X	Clinical Psychologist	PY 7220	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K7309	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1922034545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RALPH CHRISTOPHER VOTOLATO PSY. D.

Provider Business Mailing Address
First Line	:	13880 SHELL POINT PLAZA
Second Line	:	SUITE 110
City	:	FORT MYERS
State	:	FL
Zip	:	33908-3504
Country	:	US
Telephone Number	:	239-454-2146
Fax Number	:	239-454-2111

Provider Business Practice Location Address
First Line	:	13880 SHELL POINT PLAZA
Second Line	:	SUITE 110
City	:	FORT MYERS
State	:	FL
Zip	:	33908-3504
Country	:	US
Telephone Number	:	239-466-1111
Fax Number	:	239-454-2111

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

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	02/14/2022

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