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General NPI Number Information
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NPI Number | 1386216471
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Entity Type | Individual
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Provider Name | JACQUELINE TSOTETSI
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Gender | Female
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Dates
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Enumeration Date | 07/16/2021
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Last Update Date | 07/16/2021
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Provider Practice Location Address
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Address Line | 7000 W PALMETTO PARK RD STE 210
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City | BOCA RATON
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State | FL
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Zip | 33433-3430
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Country | US
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Telephone | 561-409-4490
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Fax |
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Provider Business Mailing Address
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Address Line | 606 NW 82ND AVE APT. 601
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City | PLANTATION
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State | FL
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Zip | 33324
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Country | US
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Telephone | 646-651-7129
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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 | 17972
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License Number State | FL
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