Provider Demographics
NPI:1467011692
Name:AMORIM, CAITLYN ROSE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:CAITLYN
Middle Name:ROSE
Last Name:AMORIM
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 1:523 CAMINO REAL CT APT D
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-3708
Mailing Address - Country:US
Mailing Address - Phone:305-281-8676
Mailing Address - Fax:
Practice Address - Street 1:13470 BOYETTE RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-5706
Practice Address - Country:US
Practice Address - Phone:813-336-2128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA14946224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant