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General NPI Number Information
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NPI Number | 1710678321
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Entity Type | Individual
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Provider Name | LENORE MARY SUESS COTA
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Gender | Female
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Dates
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Enumeration Date | 05/16/2023
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 2950 NW 5TH AVE
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City | BOCA RATON
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State | FL
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Zip | 33431-8226
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Country | US
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Telephone | 561-571-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 CRYSTAL WAY APT M
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City | DELRAY BEACH
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State | FL
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Zip | 33444-1006
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Country | US
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Telephone | 862-219-0232
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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 | OTA19296
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License Number State | FL
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