Provider Demographics
NPI:1134798580
Name:ENGELMAN, MICHAEL (COTA/L)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:ENGELMAN
Suffix:
Gender:M
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 1:100 BAYVIEW DR APT 2114
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4702
Mailing Address - Country:US
Mailing Address - Phone:917-559-5731
Mailing Address - Fax:
Practice Address - Street 1:100 BAYVIEW DR APT 2114
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-4702
Practice Address - Country:US
Practice Address - Phone:917-559-5731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15408224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant