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NPI Code Detail

MEDICARE: MARLEE WADDELL COTA/L

MEDICARE: MARLEE WADDELL 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 AssistantOTA18011FL

General Provider Information

NPI Number : 1891384772
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLEE WADDELL COTA/L
Provider Business Mailing Address
First Line : 20520 WIYGUL RD
Second Line :
City : UMATILLA
State : FL
Zip : 32784-8879
Country : US
Telephone Number : 352-602-3660
Fax Number :
Provider Business Practice Location Address
First Line : 606 S 9TH ST
Second Line :
City : LEESBURG
State : FL
Zip : 34748-6320
Country : US
Telephone Number : 352-805-4404
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2021
Last Update Date : 12/04/2025

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