Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | APRN9437022 | FL |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | ARNP9437022 | FL |
NPI | 1568817385 |
---|---|
Provider Name | Stefani Motkar |
First Address | Fort Myers, FL 33902-2147 |
Second Address | Fort Myers, FL 33901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2016 |
Last Update Date | 30/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
020188400 | (05) | FL |
R9GM3 | FLORIDA BLUE (01) | FL |