Provider Demographics
NPI:1205669330
Name:ROMERO, KATHERINE GABRIELA (COTA)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:GABRIELA
Last Name:ROMERO
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 1:991 S LE JEUNE RD APT 1
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33134-2660
Mailing Address - Country:US
Mailing Address - Phone:305-984-9718
Mailing Address - Fax:
Practice Address - Street 1:13155 SW 134TH ST STE 219
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4489
Practice Address - Country:US
Practice Address - Phone:305-316-5852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA19806224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant