Provider Demographics
NPI:1174892350
Name:MOTLEY, ALICIA WELDON (RPH)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:WELDON
Last Name:MOTLEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 TAMIAMI TRL N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-2535
Mailing Address - Country:US
Mailing Address - Phone:239-597-8196
Mailing Address - Fax:239-597-6705
Practice Address - Street 1:8900 TAMIAMI TRL N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-2535
Practice Address - Country:US
Practice Address - Phone:239-597-8196
Practice Address - Fax:239-597-6705
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-18
Last Update Date:2011-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS20375183500000X
VA0202005757183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist