Provider Demographics
NPI:1083185862
Name:FRANKE, JODY P (COTA-L)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:P
Last Name:FRANKE
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 1:4020 PINETREE BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33956-2429
Mailing Address - Country:US
Mailing Address - Phone:239-940-0767
Mailing Address - Fax:
Practice Address - Street 1:2629 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-5769
Practice Address - Country:US
Practice Address - Phone:239-940-0767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16930224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant