Active NPI
Gabriella Maria Bautista, COTA
- Occupational Therapy Assistant
- Miramar, FL
National Provider Identifier
1215419452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA16755
- Practice address
- 13134 SW 29TH St
Miramar, FL 33027-3837 - Phone
- (954) 249-7472
- NPI assigned
- Sep 4, 2018
- 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 | OTA16755 | FL | Primary |
Addresses
Primary practice location
13134 SW 29TH St
Miramar, FL 33027-3837
Mailing address
13134 SW 29TH St
Miramar, FL 33027-3837
Phone (954) 249-7472
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OTA16755 | Other | FL | AMERICAN OCCUPATIONAL THERAPY ASSOCIATION |
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 |
|---|---|---|---|
| OTA16755 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536019200000",
"number": "1215419452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13134 SW 29TH ST",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330273837",
"telephone_number": "954-249-7472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13134 SW 29TH ST",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330273837",
"telephone_number": "954-249-7472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUTISTA",
"first_name": "GABRIELLA",
"middle_name": "MARIA",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-04",
"last_updated": "2018-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "OTA16755",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN OCCUPATIONAL THERAPY ASSOCIATION",
"identifier": "OTA16755",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.