Active NPI
Carol Macedo, COTA
- Occupational Therapy Assistant
- St Pete Beach, FL
National Provider Identifier
1306118476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 11364
- Practice address
- 560 80TH Ave
St Pete Beach, FL 33706-1606 - Phone
- (727) 363-4566
- NPI assigned
- Feb 3, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 | 11364 | FL | Primary |
Addresses
Primary practice location
560 80TH Ave
St Pete Beach, FL 33706-1606
Mailing address
560 80TH Avenue
St Pete Beach, FL 33706
Phone (727) 363-4566
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 |
|---|---|---|---|
| 11364 | FL | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328227200000",
"number": "1306118476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "560 80TH AVENUE",
"city": "ST PETE BEACH",
"state": "FL",
"postal_code": "33706",
"telephone_number": "727-363-4566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 80TH AVE",
"city": "ST PETE BEACH",
"state": "FL",
"postal_code": "337061606",
"telephone_number": "727-363-4566"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACEDO",
"first_name": "CAROL",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-03",
"last_updated": "2012-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "FL",
"license": "11364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Pete Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.