Active NPI
Danelis Yelie Serrano Muniz, COTA/L
- Occupational Therapy Assistant
- Lakeland, FL
National Provider Identifier
1043784283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA16441
- Practice address
- 716 E Bella Vista St
Lakeland, FL 33805-3009 - Phone
- (863) 683-6504
- NPI assigned
- Jan 21, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA16441 | FL | Primary |
Addresses
Primary practice location
716 E Bella Vista St
Lakeland, FL 33805-3009
Mailing address
145 Bellaria CT
Auburndale, FL 33823-9774
Phone (407) 731-3307
Other practice location 1
3212 Hillsdale Ln
Kissimmee, FL 34741-7562
Phone (407) 906-9003
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111093400 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTA16441 | FL | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nucare Therapy LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Kissimmee, FL
- NPI 1720452550
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681171200000",
"number": "1043784283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 BELLARIA CT",
"city": "AUBURNDALE",
"state": "FL",
"postal_code": "338239774",
"telephone_number": "407-731-3307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "716 E BELLA VISTA ST",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338053009",
"telephone_number": "863-683-6504"
}
],
"practiceLocations": [
{
"address_1": "3212 Hillsdale Ln",
"address_purpose": "LOCATION",
"city": "Kissimmee",
"state": "FL",
"postal_code": "347417562",
"country_code": "US",
"telephone_number": "407-906-9003",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SERRANO MUNIZ",
"first_name": "DANELIS",
"middle_name": "YELIE",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-21",
"last_updated": "2023-04-11",
"certification_date": "2023-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "OTA16441",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "111093400",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.