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General NPI Number Information
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NPI Number | 1982368635
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Entity Type | Individual
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Provider Name | ROTHEA KIMBERLY HAMRICK COTA/L
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Gender | Female
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Dates
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Enumeration Date | 10/28/2021
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Last Update Date | 10/28/2021
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Provider Practice Location Address
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Address Line | 5725 NW 186TH ST
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City | MIAMI GARDENS
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State | FL
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Zip | 33015-6019
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Country | US
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Telephone | 305-652-9857
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Fax |
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Provider Business Mailing Address
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Address Line | 4532 SW 113TH AVE UNIT 109
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City | MIRAMAR
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State | FL
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Zip | 33025-7929
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Country | US
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Telephone | 305-469-1861
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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 | OTA12930
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License Number State | FL
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