Individual provider Active NPI

Mary Frances Laquatra, COTA/L

  • Occupational Therapy Assistant
  • Lake Worth, FL
National Provider Identifier
1407416381
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA11752 Issued in FL
Practice address
8461 Lake Worth Rd Ste 115
Lake Worth, FL 33467-2474
Phone
(561) 345-1064
NPI assigned
Jun 13, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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 OTA11752 FL Primary

Addresses

Primary practice location

8461 Lake Worth Rd Ste 115
Lake Worth, FL 33467-2474

Mailing address

10921 SW Dunhill CT
Port St Lucie, FL 34987-2403
Phone (561) 345-1064

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
OTA11752FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1407416381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10921 SW DUNHILL CT",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872403",
            "telephone_number": "561-345-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8461 LAKE WORTH RD STE 115",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672474",
            "telephone_number": "561-345-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAQUATRA",
        "first_name": "MARY",
        "middle_name": "FRANCES",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA11752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.