Provider Demographics
NPI:1861701369
Name:SANCHEZ, ROSA LINDA (COTA/L)
Entity type:Individual
Prefix:MISS
First Name:ROSA
Middle Name:LINDA
Last Name:SANCHEZ
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 1:1325 GRASSLANDS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-5405
Mailing Address - Country:US
Mailing Address - Phone:863-937-8018
Mailing Address - Fax:863-937-8019
Practice Address - Street 1:1325 GRASSLANDS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-5405
Practice Address - Country:US
Practice Address - Phone:863-937-8018
Practice Address - Fax:863-937-8019
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA10617224Z00000X
FL10617224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant