Individual provider Active NPI

Marisel Colon, COTA

  • Occupational Therapy Assistant
  • Kissimmee, FL
National Provider Identifier
1508528100
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA16929 Issued in FL
Practice address
1000 Emmett St Ste 102
Kissimmee, FL 34741-3605
Phone
(407) 913-1010
Fax
(407) 992-8697
NPI assigned
Oct 11, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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 OTA16929 FL Primary

Addresses

Primary practice location

1000 Emmett St Ste 102
Kissimmee, FL 34741-3605

Mailing address

1000 Emmett St Ste 102
Kissimmee, FL 34741-3605
Phone (407) 913-1010

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
OTA16929FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1633910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1508528100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 EMMETT ST STE 102",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347413605",
            "telephone_number": "407-913-1010",
            "fax_number": "407-992-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 EMMETT ST STE 102",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347413605",
            "telephone_number": "407-913-1010",
            "fax_number": "407-992-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON",
        "first_name": "MARISEL",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-11",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA16929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.