Healthcare Provider Details

I. General information

NPI: 1770044117
Provider Name (Legal Business Name): PIER CUENCA SANCHEZ COTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2019
Last Update Date: 03/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5970 SW 18TH ST STE E6-E7
BOCA RATON FL
33433-7197
US

IV. Provider business mailing address

5458 NW 94TH TER
SUNRISE FL
33351-7710
US

V. Phone/Fax

Practice location:
  • Phone: 954-356-2878
  • Fax:
Mailing address:
  • Phone: 954-673-4019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number17016
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: