Rolando Alicea, COTA
Individual provider Active NPI Occupational Therapy Assistant · Portage, IN
NPI 1568652170 · NPPES record last updated Jul 30, 2007
Key facts
- NPI
- 1568652170
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 32001127A (IN)
- Practice address
- 6040 Lute Rd
Portage, IN 46368-5008 - Phone
- (219) 763-6858
- Fax
- (219) 763-4858
- NPI assigned
- Jul 30, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32001127A | IN | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 32001127A | IN | Yes |
Addresses
Primary practice location
6040 Lute Rd
Portage, IN 46368-5008
Mailing address
1500 State St
Hobart, IN 46342
Phone (219) 942-9571
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32001127A | Other | IN | COTA |
Other providers in Portage, IN
- Francesco G Adamo
- Jamia Adams
- Jade Nycole Aguilar
- Muhanad Al Khatib
- Merwa Alameeri
- All About Function, PC
- Rebecca Allen
- Allusion Dental, Inc
- Ira Gail Altaras
- Jennifer Alvarez
All providers in Portage, IN · Occupational Therapy Assistant in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.