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General NPI Number Information
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NPI Number | 1265921050
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Entity Type | Individual
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Provider Name | ROSAURA VASQUEZ COTA
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Gender | Female
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 2393 S. CONGRESS AV. SUITE 130
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City | WEST PALM BEACH
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State | FL
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Zip | 33406
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Country | US
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Telephone | 561-727-7874
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Fax | 561-244-3313
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Provider Business Mailing Address
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Address Line | 2207 NW 21ST WAY
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City | BOYNTON BEACH
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State | FL
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Zip | 33436
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Country | US
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Telephone | 561-290-3289
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Fax | 561-244-3313
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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 | 15504
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License Number State | FL
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