Provider Demographics
NPI:1710678321
Name:SUESS, LENORE MARY (COTA)
Entity Type:Individual
Prefix:
First Name:LENORE
Middle Name:MARY
Last Name:SUESS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1001 CRYSTAL WAY APT M
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-1006
Mailing Address - Country:US
Mailing Address - Phone:862-219-0232
Mailing Address - Fax:
Practice Address - Street 1:2950 NW 5TH AVE
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-8226
Practice Address - Country:US
Practice Address - Phone:561-571-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA19296224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant