Provider Demographics
NPI:1609171859
Name:MAROTTI, ALESSANDRA (PSYD)
Entity Type:Individual
Prefix:MS
First Name:ALESSANDRA
Middle Name:
Last Name:MAROTTI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6601 MEMORIAL HWY STE 310
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4501
Mailing Address - Country:US
Mailing Address - Phone:813-636-8811
Mailing Address - Fax:813-636-8855
Practice Address - Street 1:4107 W SPRUCE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-2327
Practice Address - Country:US
Practice Address - Phone:813-636-8811
Practice Address - Fax:813-636-8855
Is Sole Proprietor?:No
Enumeration Date:2011-01-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7772103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007374100Medicaid
FL007374100Medicaid
FL007374100Medicaid
FLP01540045OtherRAILROAD MEDICARE PTAN