Provider Demographics
NPI:1063217065
Name:MAROTTA, JUSTIN PAUL (OTR/L, MOT)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:PAUL
Last Name:MAROTTA
Suffix:
Gender:
Credentials:OTR/L, MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E OAK ST STE D
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-4554
Mailing Address - Country:US
Mailing Address - Phone:407-847-9110
Mailing Address - Fax:
Practice Address - Street 1:501 E OAK ST STE D
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4554
Practice Address - Country:US
Practice Address - Phone:407-847-9110
Practice Address - Fax:407-847-5579
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT25935225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist