Provider Demographics
NPI:1639564222
Name:SANTAMARIA, CINDY ELIZABETH (COTA)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:ELIZABETH
Last Name:SANTAMARIA
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 1:908 POPLAR DR
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-2023
Mailing Address - Country:US
Mailing Address - Phone:561-293-6074
Mailing Address - Fax:
Practice Address - Street 1:908 POPLAR DR
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-2023
Practice Address - Country:US
Practice Address - Phone:561-293-6074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA14378224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant