Randy Roy Smith, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

A02807 Issued in MD

Practice address

3100 NW 39TH St
Lauderdale Lakes, FL 33309-4918

Phone

(954) 513-8184

NPI assigned

Aug 22, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1164079331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 NW 39TH ST",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333094918",
            "telephone_number": "954-513-8184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 NW 39TH ST",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333094918",
            "telephone_number": "954-513-8184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RANDY",
        "middle_name": "ROY",
        "name_prefix": "Mr.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MD",
            "license": "A02807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ayana Smith, LCSW
• Carole Barbara Smith, LMHC
• Iola Eunice Smith, RD, L/DN
• Nicole Smith
• Owen Oliver Smith
• Rohan Smith, MSW
• Sheri Smith
• Lauren Renee Sobelman
• Mariana Solangel, MD
• Duane Solomon

• Occupational Therapy Assistant in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Occupational Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.