Provider Demographics
NPI:1306116561
Name:KOTEI, STAN K (RPH)
Entity type:Individual
Prefix:DR
First Name:STAN
Middle Name:K
Last Name:KOTEI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1260 OAKWATER DR
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-6106
Mailing Address - Country:US
Mailing Address - Phone:561-267-7426
Mailing Address - Fax:561-793-3985
Practice Address - Street 1:101 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-2601
Practice Address - Country:US
Practice Address - Phone:561-992-0009
Practice Address - Fax:561-992-0013
Is Sole Proprietor?:No
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS45705183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist