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General NPI Number Information
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NPI Number | 1518488030
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Entity Type | Individual
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Provider Name | KAREN MARIE GRESENS COTA/L
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Gender | Female
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 609 S 9TH ST
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City | LEESBURG
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State | FL
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Zip | 34748-6319
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Country | US
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Telephone | 352-805-4404
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Fax | 877-399-5541
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Provider Business Mailing Address
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Address Line | 1200 N CENTRAL AVE STE 110
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City | KISSIMMEE
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State | FL
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Zip | 34741-4439
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Country | US
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Telephone | 386-846-4360
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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 | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State | FL
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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 | OTA15535
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | OTA15535
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License Number State | FL
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