Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 14044 | FL |
NPI | 1013399880 |
---|---|
Provider Name | Ms. Cortney Garcia |
First Address | Land O Lakes, FL 34639-6139 |
Second Address | Land O Lakes, FL 34639-6139 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2015 |
Last Update Date | 29/06/2015 |