Healthcare Provider Details

I. General information

NPI: 1396535332
Provider Name (Legal Business Name): ASHLEY LAUREN REYES COTA/L, LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 SW 1ST ST
MIAMI FL
33135-2202
US

IV. Provider business mailing address

9301 SW 92ND AVE APT C217
MIAMI FL
33176-2161
US

V. Phone/Fax

Practice location:
  • Phone: 305-541-3400
  • Fax:
Mailing address:
  • Phone: 786-387-2799
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOTA20254
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: