Provider Demographics
NPI:1942609805
Name:LAMOTTE, ROBERT STEPHEN (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:STEPHEN
Last Name:LAMOTTE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6712 US HIGHWAY 98 W
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-6900
Mailing Address - Country:US
Mailing Address - Phone:850-622-1319
Mailing Address - Fax:
Practice Address - Street 1:6712 US HIGHWAY 98 W
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-6900
Practice Address - Country:US
Practice Address - Phone:850-622-1319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-17
Last Update Date:2014-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS15140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist