Provider Demographics
NPI:1982227427
Name:KIMANZI, FLORENCE N (COTA)
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:N
Last Name:KIMANZI
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 1:26 LEBANON ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01603-1343
Mailing Address - Country:US
Mailing Address - Phone:201-563-3333
Mailing Address - Fax:
Practice Address - Street 1:26 LEBANON ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-1343
Practice Address - Country:US
Practice Address - Phone:201-563-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant