Provider Demographics
NPI:1982266961
Name:WESTON, TAYANA (COTA/L)
Entity Type:Individual
Prefix:
First Name:TAYANA
Middle Name:
Last Name:WESTON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7215 NW 179TH ST APT 306
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-6130
Mailing Address - Country:US
Mailing Address - Phone:786-326-6636
Mailing Address - Fax:
Practice Address - Street 1:12963 W OKEECHOBEE RD STE 2
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-6055
Practice Address - Country:US
Practice Address - Phone:305-397-3597
Practice Address - Fax:305-675-8040
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA-16711224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant