Provider Demographics
NPI:1689075798
Name:MADDEN, PATRICIA ANNE (COTA)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANNE
Last Name:MADDEN
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 1:6020 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-3214
Mailing Address - Country:US
Mailing Address - Phone:727-849-7555
Mailing Address - Fax:727-847-0898
Practice Address - Street 1:6020 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-3214
Practice Address - Country:US
Practice Address - Phone:727-849-7555
Practice Address - Fax:727-847-0898
Is Sole Proprietor?:No
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA6521224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant