Provider Demographics
NPI:1043559552
Name:MEADOWS, TONIA M (COTA)
Entity Type:Individual
Prefix:
First Name:TONIA
Middle Name:M
Last Name:MEADOWS
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 1:958 ODONIEL DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-2322
Mailing Address - Country:US
Mailing Address - Phone:863-255-8071
Mailing Address - Fax:
Practice Address - Street 1:958 ODONIEL DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-2322
Practice Address - Country:US
Practice Address - Phone:863-255-8071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA10805224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant