Provider Demographics
NPI:1598426512
Name:MOTT, CARMELINA MARIA
Entity type:Individual
Prefix:MS
First Name:CARMELINA
Middle Name:MARIA
Last Name:MOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CARMELA
Other - Middle Name:
Other - Last Name:FRATELLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:5091 GOLF CLUB LN
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-0314
Mailing Address - Country:US
Mailing Address - Phone:727-243-0625
Mailing Address - Fax:
Practice Address - Street 1:5091 GOLF CLUB LN
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-0314
Practice Address - Country:US
Practice Address - Phone:727-243-0625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-02
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11015227363LF0000X
FLRN2619352163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine