Provider Demographics
NPI:1184080913
Name:MONESTIME EXUM, CATHELINE (COTA)
Entity type:Individual
Prefix:
First Name:CATHELINE
Middle Name:
Last Name:MONESTIME EXUM
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:CATHELINE
Other - Middle Name:
Other - Last Name:MONESTIME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRANIAL PROSTHESIS
Mailing Address - Street 1:149 HIDDEN COURT RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33023-7466
Mailing Address - Country:US
Mailing Address - Phone:786-246-5268
Mailing Address - Fax:
Practice Address - Street 1:149 HIDDEN COURT RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33023-7466
Practice Address - Country:US
Practice Address - Phone:786-246-5268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-09
Last Update Date:2024-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLE2XZZCKQTW225000000X, 224P00000X
TX213773224Z00000X
FLOTA14951224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE2XZZCKQTWOtherCRANIAL PROSTHETIC SPECIALIST