Healthcare Provider Details

I. General information

NPI: 1649708082
Provider Name (Legal Business Name): ROMANCHES PAPAYOUTE COTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2017
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8480 RATTLESNAKE HAMMOCK RD
NAPLES FL
34114-3078
US

IV. Provider business mailing address

561 18TH ST SE
NAPLES FL
34117-9468
US

V. Phone/Fax

Practice location:
  • Phone: 239-427-2999
  • Fax:
Mailing address:
  • Phone: 813-446-1557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT20340
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: