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General NPI Number Information
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NPI Number | 1588432553
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Entity Type | Individual
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Provider Name | CHANEL JANNIS GAUZENS COTA
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Gender | Female
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Dates
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Enumeration Date | 12/19/2023
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 5651 SW 82ND AVENUE RD
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City | MIAMI
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State | FL
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Zip | 33143-1617
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Country | US
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Telephone | 305-275-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 600 CURTISS PKWY
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-5250
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Country | US
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Telephone | 786-616-5282
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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 | 19724
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License Number State | FL
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