Provider Demographics
NPI:1588202451
Name:SILVA, NATHALIA ALEXANDRE (COTA, OTR)
Entity Type:Individual
Prefix:
First Name:NATHALIA
Middle Name:ALEXANDRE
Last Name:SILVA
Suffix:
Gender:F
Credentials:COTA, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22480 LABRADOR ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33428-3978
Mailing Address - Country:US
Mailing Address - Phone:954-709-6586
Mailing Address - Fax:
Practice Address - Street 1:4324 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-5208
Practice Address - Country:US
Practice Address - Phone:954-369-5787
Practice Address - Fax:954-206-7733
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-11
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA13805224Z00000X
FLOT24456225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty