Provider Demographics
NPI:1386237949
Name:NAZARIO ROBLES, DENISE (COTA/L)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:NAZARIO ROBLES
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5418 LAKE MARGARET DR APT 1015
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-6099
Mailing Address - Country:US
Mailing Address - Phone:787-974-4917
Mailing Address - Fax:
Practice Address - Street 1:5418 LAKE MARGARET DR APT 1015
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-6099
Practice Address - Country:US
Practice Address - Phone:787-974-4917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA17573224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant