Provider Demographics
NPI:1164654109
Name:FINOTTI, JUSTIN RICHARD (COTA/L)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:RICHARD
Last Name:FINOTTI
Suffix:
Gender:M
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 1:2810 RULEME ST
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32726-6527
Mailing Address - Country:US
Mailing Address - Phone:352-357-1990
Mailing Address - Fax:
Practice Address - Street 1:2810 RULEME ST
Practice Address - Street 2:
Practice Address - City:EUSTIS
Practice Address - State:FL
Practice Address - Zip Code:32726-6527
Practice Address - Country:US
Practice Address - Phone:352-357-1990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA 11005224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant