Provider Demographics
NPI:1255776175
Name:LARIOS, YEIMI (COTA)
Entity type:Individual
Prefix:
First Name:YEIMI
Middle Name:
Last Name:LARIOS
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 1:7416 STETSON DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714-8426
Mailing Address - Country:US
Mailing Address - Phone:321-634-2394
Mailing Address - Fax:
Practice Address - Street 1:2938 STATE ROAD 33
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34714
Practice Address - Country:US
Practice Address - Phone:321-634-2394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12773224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant