Provider Demographics
NPI:1053085308
Name:RESTREPO, ISABELLA (COTA)
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:
Last Name:RESTREPO
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 1:2900 NW 125TH AVE APT 305
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-6328
Mailing Address - Country:US
Mailing Address - Phone:786-230-4902
Mailing Address - Fax:
Practice Address - Street 1:2900 NW 125TH AVE APT 305
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-6328
Practice Address - Country:US
Practice Address - Phone:786-230-4902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18449224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant