Provider Demographics
NPI:1013682111
Name:FLOTTE, ROBERTO CARLOS
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:CARLOS
Last Name:FLOTTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2308 WICKERSHAM LN APT 2006
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-4712
Mailing Address - Country:US
Mailing Address - Phone:432-438-5879
Mailing Address - Fax:
Practice Address - Street 1:2400 S CONGRESS AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-5512
Practice Address - Country:US
Practice Address - Phone:512-442-2354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX69117OtherTEXAS STATE BOARD OF PHARMACY