Provider Demographics
NPI:1043033699
Name:ROTOLO, CLAVEL AMARIZ (LM, CPM)
Entity type:Individual
Prefix:MRS
First Name:CLAVEL
Middle Name:AMARIZ
Last Name:ROTOLO
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 KRAHL RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY VIEW
Mailing Address - State:TX
Mailing Address - Zip Code:76272-4130
Mailing Address - Country:US
Mailing Address - Phone:817-962-7881
Mailing Address - Fax:
Practice Address - Street 1:1504 KRAHL RD
Practice Address - Street 2:
Practice Address - City:VALLEY VIEW
Practice Address - State:TX
Practice Address - Zip Code:76272-4130
Practice Address - Country:US
Practice Address - Phone:817-791-6670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24070519176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife