Provider Demographics
NPI:1568817385
Name:MOTKAR, STEFANI (DNP)
Entity Type:Individual
Prefix:
First Name:STEFANI
Middle Name:
Last Name:MOTKAR
Suffix:
Gender:F
Credentials:DNP
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 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-3474
Mailing Address - Fax:239-343-2968
Practice Address - Street 1:2780 CLEVELAND AVE STE 702
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901
Practice Address - Country:US
Practice Address - Phone:239-343-3474
Practice Address - Fax:239-343-2968
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9437022363LC0200X
FLAPRN9437022208M00000X, 363LA2100X
NM65896363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020188400Medicaid
FLR9GM3OtherFLORIDA BLUE