Provider Demographics
NPI:1245811587
Name:PLATT, CHARLOTTE ARABELLE (COTA)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:ARABELLE
Last Name:PLATT
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 1:3300 SAND GULLEY DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-8901
Mailing Address - Country:US
Mailing Address - Phone:321-243-7686
Mailing Address - Fax:
Practice Address - Street 1:3300 SAND GULLEY DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-8901
Practice Address - Country:US
Practice Address - Phone:321-243-7686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18006224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant