Individual
JONATHAN WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
7350 DAIRY RD, ZEPHYRHILLS, FL 33540-1354
(813) 788-4300
Mailing address
30734 MIDTOWN CT, WESLEY CHAPEL, FL 33545-1332
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
19014
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H77328834
—
FL
Enumeration date
06/30/2022
Last updated
06/30/2022
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