Provider Demographics
NPI:1518454891
Name:COTHIAS, GUIRLENE
Entity Type:Individual
Prefix:
First Name:GUIRLENE
Middle Name:
Last Name:COTHIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 PLYMOUTH SORRENTO RD
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-5616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 E NIGHTINGALE ST
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-2709
Practice Address - Country:US
Practice Address - Phone:407-464-0039
Practice Address - Fax:407-814-0168
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-22
Last Update Date:2018-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities