Provider Demographics
NPI:1801199096
Name:CARTER, LAKESHA ANN (COTA)
Entity Type:Individual
Prefix:MS
First Name:LAKESHA
Middle Name:ANN
Last Name:CARTER
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 1:125 NW 109TH AVE
Mailing Address - Street 2:APT #301
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-5114
Mailing Address - Country:US
Mailing Address - Phone:954-435-5040
Mailing Address - Fax:
Practice Address - Street 1:301 NE 141ST ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-2837
Practice Address - Country:US
Practice Address - Phone:305-893-1102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-10
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA#8929224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant