Provider Demographics
NPI:1700118742
Name:AMABILE, LUIGI JR (COTA)
Entity Type:Individual
Prefix:
First Name:LUIGI
Middle Name:
Last Name:AMABILE
Suffix:JR
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 ENGLAR DR
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-5519
Mailing Address - Country:US
Mailing Address - Phone:772-713-7493
Mailing Address - Fax:
Practice Address - Street 1:25325 RAMPART BLVD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33983-6404
Practice Address - Country:US
Practice Address - Phone:352-682-4449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant