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General NPI Number Information
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NPI Number | 1083026637
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Entity Type | Individual
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Provider Name | CARLENE CABOT
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Gender | Female
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Dates
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Enumeration Date | 05/29/2014
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Last Update Date | 08/30/2015
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Provider Practice Location Address
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Address Line | 5535 S WILLIAMSON BLVD SUITE 774
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City | PORT ORANGE
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State | FL
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Zip | 32128-8311
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Country | US
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Telephone | 800-330-7711
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Fax | 386-944-7202
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Provider Business Mailing Address
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Address Line | 5535 S WILLIAMSON BLVD SUITE 774
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City | PORT ORANGE
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State | FL
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Zip | 32128-8311
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Country | US
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Telephone | 800-330-7711
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Fax | 386-944-7202
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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 | A02099
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OP007184
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA1298
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License Number State | ID
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Taxonomy #4
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 46TA09101800
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License Number State | NJ
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Taxonomy #5
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OC60452792
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License Number State | WA
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