Provider Demographics
NPI:1760873061
Name:GEVA, DANIELLE (COTA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:GEVA
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 1:3132 FLORAL WAY E
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-6610
Mailing Address - Country:US
Mailing Address - Phone:407-808-0571
Mailing Address - Fax:
Practice Address - Street 1:5245 N SOCRUM LOOP RD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-4253
Practice Address - Country:US
Practice Address - Phone:863-859-1446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-09
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP009285224Z00000X
FLOTA 14164224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant