Organization
ARTISTIC THERAPLAY
Active
Organization
ARTISTIC THERAPLAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA MARIA VENTURA COTA (CEO)
(863) 651-7516
Entity
Organization
Contact information
Practice address
3631 HAVENDALE BLVD STE C, AUBURNDALE, FL 33823-4605
(863) 651-7516
Mailing address
101 BRIGHTON WAY, AUBURNDALE, FL 33823-2161
(863) 651-7516
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/22/2019
Last updated
03/29/2022
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