MEDICARE: CATHELINE MONESTIME EXUM COTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224P00000X	Prosthetist	E2XZZCKQTW	FL
2	224Z00000X	Occupational Therapy Assistant	OTA14951	FL
3	224Z00000X	Occupational Therapy Assistant	213773	TX
4	225000000X	Orthotic Fitter	E2XZZCKQTW	FL
5	106S00000X	Behavior Technician	BACB1230135	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	E2XZZCKQTW	OTHER	FL	CRANIAL PROSTHETIC SPECIALIST

General Provider Information

NPI Number	:	1184080913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHELINE MONESTIME EXUM COTA

Provider Business Mailing Address
First Line	:	149 HIDDEN COURT RD
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33023-7466
Country	:	US
Telephone Number	:	786-246-5268
Fax Number	:

Provider Business Practice Location Address
First Line	:	5420 NW 33RD AVE STE 6
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33309-6387
Country	:	US
Telephone Number	:	786-246-5268
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2016
Last Update Date	:	02/06/2026

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Directions to “ CATHELINE MONESTIME EXUM COTA” Practice Location

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