Individual
KENNY TORRES CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
112 W CITRUS ST, ALTAMONTE SPRINGS, FL 32714-2502
(407) 865-5642
(407) 865-5646
Mailing address
112 W CITRUS ST, ALTAMONTE SPRINGS, FL 32714-2502
(407) 865-5642
(407) 865-5646
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18060
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18060
LICENSE NUMBER COTA/L
FL
Enumeration date
02/09/2021
Last updated
02/09/2021
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