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General NPI Number Information
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NPI Number | 1568349462
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Entity Type | Individual
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Provider Name | STEPHANIE LYNN PARKINSON COTA/L
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Gender | Female
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 21281 GRAYTON TER
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City | PORT CHARLOTTE
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State | FL
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Zip | 33954-3109
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Country | US
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Telephone | 941-613-0919
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Fax |
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Provider Business Mailing Address
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Address Line | 1651 LOG LN
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City | NORTH PORT
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State | FL
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Zip | 34286-5206
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Country | US
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Telephone | 941-303-7662
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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 | OTA20334
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License Number State | FL
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