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General NPI Number Information
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NPI Number | 1073014874
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Entity Type | Individual
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Provider Name | KAYLIE M SCHWARTZ COTA/L
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Gender | Female
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Dates
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Enumeration Date | 02/27/2018
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Last Update Date | 02/27/2018
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Provider Practice Location Address
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Address Line | 3201 BUDINGER AVE
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City | SAINT CLOUD
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State | FL
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Zip | 34769-7203
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Country | US
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Telephone | 888-477-7678
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Fax |
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Provider Business Mailing Address
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Address Line | 3016 SAVANNAH WAY APT 206
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City | MELBOURNE
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State | FL
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Zip | 32935-3639
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Country | US
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Telephone | 321-203-8345
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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 | OTA16377
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License Number State | FL
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