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General NPI Number Information
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NPI Number | 1023997822
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Entity Type | Individual
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Provider Name | AMANDA LEIGH GILBERT COTA/L
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Gender | Female
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 1248 KINGSLEY AVE
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City | ORANGE PARK
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State | FL
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Zip | 32073-4699
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Country | US
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Telephone | 904-264-0207
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Fax |
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Provider Business Mailing Address
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Address Line | 1232 LOCH TANNA LOOP
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City | ST JOHNS
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State | FL
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Zip | 32259-5483
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Country | US
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Telephone | 864-608-2621
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA19611
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License Number State | FL
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