Individual
JUSTIN MATHEW THOTTAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6200 SUNSET DR STE 120, MIAMI, FL 33143-4832
(786) 596-3876
(786) 533-9989
Mailing address
PO BOX 198054, ATLANTA, GA 30384-8054
(786) 596-3876
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
34.013312
OH
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS15910
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2014
Last updated
07/13/2022
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