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NPI Code Detail

MEDICARE: DAVID MICHAEL STOLTZ COTA/L

MEDICARE: DAVID MICHAEL STOLTZ 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 AssistantOTA11439FL

General Provider Information

NPI Number : 1336709997
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID MICHAEL STOLTZ COTA/L
Provider Business Mailing Address
First Line : 5792 AVOCADO BLVD
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33411-8316
Country : US
Telephone Number : 352-287-9797
Fax Number :
Provider Business Practice Location Address
First Line : 3101 GINGER DR
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-4437
Country : US
Telephone Number : 850-877-2177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2019
Last Update Date : 06/17/2019

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