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NPI Code Detail

MEDICARE: TERESA HUYEN THI MY HOANG COTA/L

MEDICARE:   TERESA HUYEN THI MY HOANG  COTA/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantOTA11280FL

General Provider Information

NPI Number : 1316367535
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA HUYEN THI MY HOANG COTA/L
Provider Business Mailing Address
First Line : 2025 FREEPORT DR
Second Line :
City : RIVIERA BEACH
State : FL
Zip : 33404-6465
Country : US
Telephone Number : 321-626-8344
Fax Number :
Provider Business Practice Location Address
First Line : 2025 FREEPORT DR
Second Line :
City : RIVIERA BEACH
State : FL
Zip : 33404-6465
Country : US
Telephone Number : 321-626-8344
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2014
Last Update Date : 04/27/2014

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Directions to “ TERESA HUYEN THI MY HOANG COTA/L” Practice Location

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