Individual provider Active NPI

Paola Judith Jusino Camacho, COTA/L

  • Occupational Therapy Assistant
  • Wesley Chapel, FL
National Provider Identifier
1275294654
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA18652 Issued in FL
Practice address
6343 Angus Valley Dr
Wesley Chapel, FL 33544-5826
Phone
(407) 520-1681
NPI assigned
Jan 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA18652 FL Primary

Addresses

Primary practice location

6343 Angus Valley Dr
Wesley Chapel, FL 33544-5826

Mailing address

6343 Angus Valley Dr
Wesley Chapel, FL 33544-5826
Phone (407) 520-1681

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

LicenseStateTypeSpecialty
OTA18652FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1275294654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6343 ANGUS VALLEY DR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335445826",
            "telephone_number": "407-520-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6343 ANGUS VALLEY DR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335445826",
            "telephone_number": "407-520-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSINO CAMACHO",
        "first_name": "PAOLA",
        "middle_name": "JUDITH",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA18652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; 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.