Provider Demographics
NPI:1316173594
Name:MAROTTE, KAREN A (LMT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:A
Last Name:MAROTTE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 495664
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33949-5664
Mailing Address - Country:US
Mailing Address - Phone:941-625-2500
Mailing Address - Fax:
Practice Address - Street 1:2726 TAMIAMI TRL
Practice Address - Street 2:UNIT F
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5164
Practice Address - Country:US
Practice Address - Phone:941-625-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA32252172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker