Provider Demographics
NPI:1902212004
Name:GASCOT, KRISTY LEE (COTA/L)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:LEE
Last Name:GASCOT
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5025 SW 100TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-6342
Mailing Address - Country:US
Mailing Address - Phone:786-202-4733
Mailing Address - Fax:
Practice Address - Street 1:2828 CORAL WAY
Practice Address - Street 2:SUITE 205
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33145-3214
Practice Address - Country:US
Practice Address - Phone:304-443-2022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL307217171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor