Provider Demographics
NPI:1245814441
Name:ROMERO, KATRINA (COTA)
Entity type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:
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 1:12330 CITRUSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5734
Mailing Address - Country:US
Mailing Address - Phone:407-697-9222
Mailing Address - Fax:
Practice Address - Street 1:13807 LANDSTAR BLVD STE 136
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32824-5530
Practice Address - Country:US
Practice Address - Phone:407-281-3803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18231224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant