Provider Demographics
NPI:1194001453
Name:HALL, LUVELLA (COTA)
Entity Type:Individual
Prefix:
First Name:LUVELLA
Middle Name:
Last Name:HALL
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 1:5201 DESOTO RD
Mailing Address - Street 2:SUITE 343
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34235-3607
Mailing Address - Country:US
Mailing Address - Phone:941-554-8132
Mailing Address - Fax:
Practice Address - Street 1:5201 DESOTO RD
Practice Address - Street 2:SUITE 343
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34235-3607
Practice Address - Country:US
Practice Address - Phone:941-554-8132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA11370224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant