Active NPI
Mary Frances Laquatra, COTA/L
- Occupational Therapy Assistant
- Lake Worth, FL
National Provider Identifier
1407416381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- OTA11752
- 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
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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| OTA11752 | FL | MD | Occupational 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.