Provider Demographics
NPI:1194904219
Name:SULLIVAN, ERICA DANIELLE (COTA)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:DANIELLE
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14055 TOWN LOOP BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-6106
Mailing Address - Country:US
Mailing Address - Phone:407-857-6285
Mailing Address - Fax:407-857-9566
Practice Address - Street 1:14055 TOWN LOOP BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6106
Practice Address - Country:US
Practice Address - Phone:407-857-6285
Practice Address - Fax:407-857-9566
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19776224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant